Suppr超能文献

重症监护病房获得性神经肌肉无力:一项关于发病率、临床病程及结局的前瞻性研究。

Intensive Care Unit-acquired Neuromuscular Weakness: A Prospective Study on Incidence, Clinical Course, and Outcomes.

作者信息

Baby Skaria, George Christina, Osahan Narjeet M

机构信息

Department of Anaesthesiology and Critical Care, MOSC Medical College, Kolenchery, Kerala, India.

Department of Anaesthesia and Critical Care, CMC Hospital, Ludhiana, Punjab, India.

出版信息

Indian J Crit Care Med. 2021 Sep;25(9):1006-1012. doi: 10.5005/jp-journals-10071-23975.

Abstract

BACKGROUND

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.

AIMS AND OBJECTIVES

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.

METHODS

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.

RESULTS AND CONCLUSION

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.

HOW TO CITE THIS ARTICLE

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.

摘要

背景

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。

目的

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。

方法

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。

结果与结论

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%。

如何引用本文

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e415/8664033/475594281d1c/ijccm-25-1006-g001.jpg

相似文献

1
Intensive Care Unit-acquired Neuromuscular Weakness: A Prospective Study on Incidence, Clinical Course, and Outcomes.
Indian J Crit Care Med. 2021 Sep;25(9):1006-1012. doi: 10.5005/jp-journals-10071-23975.
4
Use of handgrip dynamometry for diagnosis and prognosis assessment of intensive care unit acquired weakness: A prospective study.
Heart Lung. 2019 Nov-Dec;48(6):532-537. doi: 10.1016/j.hrtlng.2019.07.001. Epub 2019 Jul 15.
5
Hyperlactacidemia as a risk factor for intensive care unit-acquired weakness in critically ill adult patients.
Muscle Nerve. 2021 Jul;64(1):77-82. doi: 10.1002/mus.27248. Epub 2021 Apr 21.
6
Incidence, Time Course and Influence on Quality of Life of Intensive Care Unit-Acquired Weakness Symptoms in Long-Term Intensive Care Survivors.
J Intensive Care Med. 2021 Nov;36(11):1313-1322. doi: 10.1177/0885066620949178. Epub 2020 Aug 17.
9
Clinical review: intensive care unit acquired weakness.
Crit Care. 2015 Aug 5;19(1):274. doi: 10.1186/s13054-015-0993-7.

引用本文的文献

1
Perme Score and Machine Learning for Detecting ICU-acquired Weakness: A Prospective Observational Cohort Study.
Indian J Crit Care Med. 2025 Jul;29(7):562-568. doi: 10.5005/jp-journals-10071-25011. Epub 2025 Jul 7.
3
PEI/MMNs@LNA-542 nanoparticles alleviate ICU-acquired weakness through targeted autophagy inhibition and mitochondrial protection.
Open Life Sci. 2024 Sep 9;19(1):20220952. doi: 10.1515/biol-2022-0952. eCollection 2024.
5
Intensive Care Unit-acquired Weakness: A Frequent but Under-recognized Threat.
Indian J Crit Care Med. 2021 Sep;25(9):965-966. doi: 10.5005/jp-journals-10071-23990.

本文引用的文献

1
Clinical review: intensive care unit acquired weakness.
Crit Care. 2015 Aug 5;19(1):274. doi: 10.1186/s13054-015-0993-7.
3
Acute outcomes and 1-year mortality of intensive care unit-acquired weakness. A cohort study and propensity-matched analysis.
Am J Respir Crit Care Med. 2014 Aug 15;190(4):410-20. doi: 10.1164/rccm.201312-2257OC.
4
ICU-acquired weakness and recovery from critical illness.
N Engl J Med. 2014 Apr 24;370(17):1626-35. doi: 10.1056/NEJMra1209390.
5
Effect of tolerating macronutrient deficit on the development of intensive-care unit acquired weakness: a subanalysis of the EPaNIC trial.
Lancet Respir Med. 2013 Oct;1(8):621-629. doi: 10.1016/S2213-2600(13)70183-8. Epub 2013 Sep 10.
6
What is new in prevention of muscle weakness in critically ill patients?
Intensive Care Med. 2013 Dec;39(12):2200-3. doi: 10.1007/s00134-013-3132-4. Epub 2013 Oct 24.
8
ICU-acquired weakness - a call to arms (and legs).
Crit Care Resusc. 2011 Mar;13(1):3-4.
9
Rapidly progressive diaphragmatic weakness and injury during mechanical ventilation in humans.
Am J Respir Crit Care Med. 2011 Feb 1;183(3):364-71. doi: 10.1164/rccm.201004-0670OC. Epub 2010 Sep 2.
10
Critical illness myopathy is frequent: accompanying neuropathy protracts ICU discharge.
J Neurol Neurosurg Psychiatry. 2011 Mar;82(3):287-93. doi: 10.1136/jnnp.2009.192997. Epub 2010 Aug 27.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验