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[重症监护病房获得性肌无力]

[Intensive Care Unit-Acquired Weakness].

作者信息

Siao Shu-Fen, Yen Yu-Huei, Yu Ya-Fang, Zong Sheng-Lan, Chen Chia-Hui Cheryl

机构信息

BSN, RN, Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC.

MSN, RN, Department of Nursing, Taoyuan Armed Forces General Hospital, Taiwan, ROC.

出版信息

Hu Li Za Zhi. 2020 Jun;67(3):6-13. doi: 10.6224/JN.202006_67(3).02.

Abstract

Intensive care unit (ICU)-acquired weakness is a common neuromuscular complication of critical illness that is considered to be associated with prolonged duration on mechanical ventilation and systemic inflammatory response syndrome. In addition, nutrition and metabolic alternations, which are commonly seen in patients in the ICU, may further accelerate muscle wasting and increase the incidence of ICU-acquired weakness. The clinical features of ICU-acquired weakness include acute generalized muscle weakness that develops after the onset of critical illness. Diaphragmatic dysfunction, post-extubation dysphagia, and functional decline also are common in patients with ICU-acquired weakness. As the recovery of these physical functions is lengthy and difficult, a multidisciplinary team management is recommended. This mini-review was conducted to provide a scientific overview for ICU-acquired weakness, including its definition, etiology, diagnosis/screening, impacts, and potential intervention strategies. We hope that increasing the understanding of frontline staff will promote the timely planning and implementation of related screenings and interventions to enhance the functional recovery of patients receiving care in the ICU.

摘要

重症监护病房(ICU)获得性肌无力是危重病常见的神经肌肉并发症,被认为与机械通气时间延长及全身炎症反应综合征有关。此外,ICU患者中常见的营养和代谢改变可能会进一步加速肌肉萎缩,并增加ICU获得性肌无力的发生率。ICU获得性肌无力的临床特征包括危重病发作后出现的急性全身性肌无力。膈肌功能障碍、拔管后吞咽困难和功能下降在ICU获得性肌无力患者中也很常见。由于这些身体功能的恢复漫长且困难,建议采用多学科团队管理。本综述旨在对ICU获得性肌无力进行科学概述,包括其定义、病因、诊断/筛查、影响及潜在干预策略。我们希望增进一线医护人员的了解,将促进及时规划和实施相关筛查及干预措施,以提高ICU患者的功能恢复情况。

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