Intensive Care Unit–acquired Muscle Weakness

2016 ◽  
Vol 124 (1) ◽  
pp. 7-9
Author(s):  
Angela K. M. Lipshutz ◽  
Michael A. Gropper
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Muscle Weakness

scholarly journals Global Muscle Strength But Not Grip Strength Predicts Mortality and Length of Stay in a General Population in a Surgical Intensive Care Unit

2012 ◽  
Vol 92 (12) ◽  
pp. 1546-1555 ◽  
Author(s):  
Jeanette J. Lee ◽  
Karen Waak ◽  
Martina Grosse-Sundrup ◽  
Feifei Xue ◽  
Jarone Lee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Grip Strength ◽  
Muscle Weakness ◽  
Manual Muscle Testing ◽  
Surgical Intensive Care Unit ◽  
Muscle Testing

Background Paresis acquired in the intensive care unit (ICU) is common in patients who are critically ill and independently predicts mortality and morbidity. Manual muscle testing (MMT) and handgrip dynamometry assessments have been used to evaluate muscle weakness in patients in a medical ICU, but similar data for patients in a surgical ICU (SICU) are limited. Objective The purpose of this study was to evaluate the predictive value of strength measured by MMT and handgrip dynamometry at ICU admission for in-hospital mortality, SICU length of stay (LOS), hospital LOS, and duration of mechanical ventilation. Design This investigation was a prospective, observational study. Methods One hundred ten patients were screened for eligibility for testing in the SICU of a large, academic medical center. The Acute Physiology and Chronic Health Evaluation (APACHE) II score, diagnoses, and laboratory data were collected. Measurements were obtained by MMT quantified with the sum (total) score on the Medical Research Council Scale and by handgrip dynamometry. Outcome data, including in-hospital mortality, SICU LOS, hospital LOS, and duration of mechanical ventilation, were collected for all participants. Results One hundred seven participants were eligible for testing; 89% were tested successfully at a median of 3 days (25th–75th percentiles=3–6 days) after admission. Sedation was the most frequent barrier to testing (70.6%). Manual muscle testing was identified as an independent predictor of mortality, SICU LOS, hospital LOS, and duration of mechanical ventilation. Grip strength was not independently associated with these outcomes. Limitations This study did not address whether muscle weakness translates to functional outcome impairment. Conclusions In contrast to handgrip strength, MMT reliably predicted in-hospital mortality, duration of mechanical ventilation, SICU LOS, and hospital LOS.

Profile of muscle weakness in a medical-surgical intensive care unit

2017 ◽  
Vol 42 ◽  
pp. 406
Author(s):  
José Aires de Araújo Neto ◽  
Roberta Fernandes Bomfim ◽  
Fernando Beserra Lima ◽  
Aline Carvalho Gouveia ◽  
Alda Silva Lopes ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Muscle Weakness ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care

Care and treatments related to intensive care unit–acquired muscle weakness: A cohort study

2021 ◽  
Author(s):  
M. Raurell-Torredà ◽  
S. Arias-Rivera ◽  
J.D. Martí ◽  
M.J. Frade-Mera ◽  
I. Zaragoza-García ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Muscle Weakness

Acquired Muscle Weakness in the Surgical Intensive Care Unit

2016 ◽  
Vol 124 (1) ◽  
pp. 207-234 ◽  
Author(s):  
Hassan Farhan ◽  
Ingrid Moreno-Duarte ◽  
Nicola Latronico ◽  
Ross Zafonte ◽  
Matthias Eikermann
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Muscle Weakness ◽  
Prolonged Mechanical Ventilation ◽  
Underlying Mechanism ◽  
Time Frame ◽  
Adverse Outcomes ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Drug Induced

Abstract Muscle weakness is common in the surgical intensive care unit (ICU). Low muscle mass at ICU admission is a significant predictor of adverse outcomes. The consequences of ICU-acquired muscle weakness depend on the underlying mechanism. Temporary drug-induced weakness when properly managed may not affect outcome. Severe perioperative acquired weakness that is associated with adverse outcomes (prolonged mechanical ventilation, increases in ICU length of stay, and mortality) occurs with persistent (time frame: days) activation of protein degradation pathways, decreases in the drive to the skeletal muscle, and impaired muscular homeostasis. ICU-acquired muscle weakness can be prevented by early treatment of the underlying disease, goal-directed therapy, restrictive use of immobilizing medications, optimal nutrition, activating ventilatory modes, early rehabilitation, and preventive drug therapy. In this article, the authors review the nosology, epidemiology, diagnosis, and prevention of ICU-acquired weakness in surgical ICU patients.

Effects of corticosteroids in the development of limb muscle weakness in a porcine intensive care unit model

2013 ◽  
Vol 45 (8) ◽  
pp. 312-320 ◽  
Author(s):  
Sudhakar Aare ◽  
Peter Radell ◽  
Lars I. Eriksson ◽  
Hazem Akkad ◽  
Yi-Wen Chen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Muscle Weakness ◽  
Biceps Femoris ◽  
Limb Muscle ◽  
Negative Effects ◽  
Icu Patients ◽  
Altered Expression ◽  
The Impact

Severe muscle wasting is a debilitating condition in critically ill intensive care unit (ICU) patients, characterized by general muscle weakness and dysfunction, resulting in a prolonged mobilization, delayed weaning from the ventilator, and a decreased quality of life post-ICU. The mechanisms underlying limb muscle weakness in ICU patients are complex and involve the impact of primary disease, but also factors common to critically ill ICU patients such as sepsis, mechanical ventilation (MV), immobilization, and systemic administration of corticosteroids (CS). These factors may have additive negative effects on skeletal muscle structure and function, but their respective role alone remain unknown. The primary aim of this study was to examine how CS administration potentiates ventilator and immobilization-related limb muscle dysfunction at the gene level. Comparing biceps femoris gene expression in pigs exposed to MV and CS for 5 days with only MV pigs for the same duration of time showed a distinct deregulation of 186 genes according to microarray. Surprisingly, the decreased force-generation capacity at the single muscle fiber reported in response to the addition of CS administration in mechanically ventilated and immobilized pigs was not associated with an additional upregulation of proteolytic pathways. On the other hand, an altered expression of genes regulating kinase activity, cell cycle, transcription, channel regulation, oxidative stress response, cytoskeletal, sarcomeric, and heat shock protein, as well as protein synthesis at the translational level, appears to play an additive deleterious role for the limb muscle weakness in immobilized ICU patients.

Sign in / Sign up

Export Citation Format

Share Document