Chang Lawrence G, Zar Safwan, Seidel Benjamin, Kurra Anupama, Gitkind Andrew
Sports Medicine, Montefiore Medical Center, Bronx, USA.
Physical Medicine and Rehabilitation, Burke Rehabilitation Hospital, White Plains, USA.
Cureus. 2021 Apr 8;13(4):e14374. doi: 10.7759/cureus.14374.
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causing the coronavirus disease 2019 (COVID-19) pandemic is known to lead to the complicated sequelae of severe acute respiratory distress syndrome. Proning has been used as an adjunctive treatment to improve oxygenation in both ventilated and non-ventilated patients. Although patients respond well to this strategy, complications from this arise as well. It is hypothesized that COVID-19 intensive care unit (ICU) proned ventilation is associated with new cases of foot drops or compressive unilateral ankle dorsiflexion weakness during the early 2020 COVID-19 pandemic. Five patients presented to an acute rehabilitation facility with unilateral ankle dorsiflexion weakness after ICU proned ventilation during the COVID-19 pandemic. Three patients were found to have primarily subacute left sensory-motor dysmyelinating common peroneal neuropathies located around the fibular head. Two patients were found to have primarily subacute sensory-motor dysmyelinating right-sided common peroneal neuropathies above the fibular head and distal to biceps femoris muscle. Compressive unilateral common peroneal neuropathies during the pandemic are possibly related to the impromptu, unconventional, and unfamiliar use of proned ventilation.
引发2019冠状病毒病（COVID-19）大流行的新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）已知会导致严重急性呼吸窘迫综合征的复杂后遗症。俯卧位通气已被用作辅助治疗手段，以改善接受机械通气和未接受机械通气患者的氧合情况。尽管患者对这一策略反应良好，但也会由此引发并发症。据推测，在2020年早期COVID-19大流行期间，COVID-19重症监护病房（ICU）的俯卧位通气与足下垂新病例或单侧踝关节背屈压迫性无力有关。在COVID-19大流行期间，有5名患者在ICU进行俯卧位通气后，因单侧踝关节背屈无力而被送至一家急性康复机构。其中3名患者主要患有位于腓骨头周围的亚急性左侧感觉运动脱髓鞘性腓总神经病变。另外2名患者主要患有位于腓骨头上方且在股二头肌远端的亚急性右侧感觉运动脱髓鞘性腓总神经病变。大流行期间的单侧腓总神经压迫性病变可能与临时、非常规且不熟悉的俯卧位通气使用有关。
