Baby Skaria, George Christina, Osahan Narjeet M
Department of Anaesthesiology and Critical Care, MOSC Medical College, Kolenchery, Kerala, India.
Department of Anaesthesia and Critical Care, CMC Hospital, Ludhiana, Punjab, India.
Indian J Crit Care Med. 2021 Sep;25(9):1006-1012. doi: 10.5005/jp-journals-10071-23975.
Neuromuscular weakness may manifest subsequent to critical illness in intensive care unit (ICU) patients. This weakness termed as "ICU-acquired weakness" (ICUAW) has a significant bearing on the length of mechanical ventilation, duration of ICU stays, long-term disability, and survival rate. Early identification of ICUAW helps in planning appropriate strategies, as well as in predicting the prognosis and long-term outcomes of these patients.
To identify the incidence of new-onset neuromuscular weakness developing among patients admitted in the ICU (ICUAW) and study its clinical course and impact on the duration of ICU stay.
This prospective observational study evaluated patients admitted to the ICU over a period of 1 year and 3 months (November 1, 2015, to January 31, 2017). All patients fulfilling the inclusion and exclusion criteria were evaluated with the Medical Research Council (MRC) score for muscle strength. Patients with an average score <4 were diagnosed with ICUAW. Included patients were examined on alternate days to study the clinical progression of the weakness till ICU discharge or death of the patient. The duration of ICU stay was noted.
The study revealed a significant association of ICUAW with age, Acute Physiology And Chronic Health Evaluation (APACHE II) Score, duration of mechanical ventilation, and ICU mortality. The incidence of the weakness was found to be 7.83% among the patients who survived and 50% among those patients who did not survive critical illness.
Baby S, George C, Osahan NM. Intensive Care Unit-acquired Neuromuscular Weakness: A Prospective Study on Incidence, Clinical Course, and Outcomes. Indian J Crit Care Med 2021;25(9):1006-1012.
神经肌肉无力可能在重症监护病房(ICU)患者患危重病后出现。这种被称为“ICU获得性肌无力”(ICUAW)的无力对机械通气时间、ICU住院时间、长期残疾和生存率有重大影响。早期识别ICUAW有助于制定适当的策略,以及预测这些患者的预后和长期结局。
确定入住ICU的患者中发生的新发神经肌肉无力(ICUAW)的发生率,并研究其临床病程及其对ICU住院时间的影响。
这项前瞻性观察性研究评估了在1年零3个月(2015年11月1日至2017年1月31日)期间入住ICU的患者。所有符合纳入和排除标准的患者均采用医学研究委员会(MRC)肌力评分进行评估。平均评分<4分的患者被诊断为ICUAW。对纳入的患者每隔一天进行检查,以研究肌无力的临床进展,直至患者出院或死亡。记录ICU住院时间。
该研究揭示了ICUAW与年龄、急性生理与慢性健康状况评估(APACHE II)评分、机械通气时间和ICU死亡率之间存在显著关联。在存活的患者中,肌无力的发生率为7.83%,在未从危重病中存活的患者中为50%。
Baby S, George C, Osahan NM. 重症监护病房获得性神经肌肉无力:发病率、临床病程及结局的前瞻性研究。《印度重症监护医学杂志》2021;25(9):1006 - 1012。