scholarly journals Acquired peripheral nerve injuries associated with severe COVID-19

2021 ◽  
Author(s):  
Colin K. Franz ◽  
Nikhil K. Murthy ◽  
George R. Malik ◽  
Jean W. Kwak ◽  
Dom D’Andrea ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Peripheral Nerve ◽  
Acute Care ◽  
Pressure Sensor ◽  
Case Series ◽  
Intensive Care Unit Setting ◽  
Proof Of Concept ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

AbstractWe diagnosed 63 peripheral nerve injuries in 32 patients who survived severe COVID-19. We combine our latest data with published case series re-analyzed here (106 nerve injuries; 49 patients) to provide a comprehensive accounting of lesion sites. The most common are ulnar (26.0%), common fibular (16.0%), median (10.7%), sciatic (10.7%), brachial plexus (9.5%) and radial (8.3%) nerves. Nerve injury prevention should be prioritized during acute care of COVID-19 patients. To this end, we report proof of concept data of a wearable, wireless pressure sensor to provide real time monitoring in the intensive care unit setting.

scholarly journals Intensive Care Unit-Acquired Weakness and Positioning-Related Peripheral Nerve Injuries in COVID-19: A Case Series of Three Patients and the Latest Literature Review

2021 ◽  
Vol 11 (9) ◽  
pp. 1177
Author(s):  
Keiichi Hokkoku ◽  
Carmen Erra ◽  
Cristina Cuccagna ◽  
Daniele Coraci ◽  
Dario Mattia Gatto ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Peripheral Nerve ◽  
Case Series ◽  
Medical Attention ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Muscle Mri ◽  
Prolonged Immobilization

A subgroup of COVID-19 patients requires intensive respiratory care. The prolonged immobilization and aggressive treatments predispose these patients to develop intensive care unit-acquired weakness (ICUAW). Furthermore, this condition could increase the chance of positioning-related peripheral nerve injuries. On the basis of the latest literature review, we describe a case series of three patients with COVID-19 who developed ICUAW complicated by positioning-related peripheral nerve injuries Every patient presented sensorimotor axonal polyneuropathy and concomitant myopathy in electrophysiological studies. Furthermore, muscle MRI helped the diagnosis of ICUAW, showing massive damage predominantly in the proximal muscles. Notably, nerve ultrasound detected positioning-related peripheral nerve injuries, even though the concomitant ICUAW substantially masked their clinical features. During the acute phase of severe COVID-19 infection, most medical attention tends to be assigned to critical care management, and neuromuscular complications such as ICUAW and positioning-related peripheral nerve injuries could be underestimated. Hence, when starting post-ICU care for COVID-19 cases, the combination of electrophysiological and imaging studies will aid appropriate evaluation on the patients with COVID-19-related ICUAW.

Peripheral Nerve Injuries in Athletes: A Case Series of Over 200 Injuries

2000 ◽  
Vol 20 (02) ◽  
pp. 225-232 ◽  
Author(s):  
Lisa S. Krivickas ◽  
Asa J. Wilbourn
Keyword(s):  
Peripheral Nerve ◽  
Case Series ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

scholarly journals A Retrospective Case Series Reporting the Outcomes of Avance Nerve Allografts in the Treatment of Peripheral Nerve Injuries

2020 ◽  
Vol 145 (2) ◽  
pp. 368e-381e ◽  
Author(s):  
Jonathan I. Leckenby ◽  
Curdin Furrer ◽  
Luzian Haug ◽  
Bettina Juon Personeni ◽  
Esther Vögelin
Keyword(s):  
Peripheral Nerve ◽  
Case Series ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Retrospective Case ◽  
Retrospective Case Series

scholarly journals Brachial Plexus Neuropathies During the COVID-19 Pandemic: A Retrospective Case Series of 15 Patients in Critical Care

2020 ◽  
Vol 101 (1) ◽  
Author(s):  
Caroline Miller ◽  
Joel O'Sullivan ◽  
Jack Jeffrey ◽  
Dominic Power
Keyword(s):  
Critical Care ◽  
United Kingdom ◽  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Nerve Injury ◽  
Upper Limb ◽  
Case Series ◽  
Queen Elizabeth Hospital ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

Abstract Objective The use of the prone position to treat patients with COVID-19 pneumonia who are critically ill and mechanically ventilated is well documented. This case series reports the location, severity, and prevalence of focal peripheral nerve injuries involving the upper limb identified in an acute COVID-19 rehabilitation setting. The purpose of this study was to report observations and to explore the challenges in assessing these patients. Methods Participants were patients with suspected peripheral nerve injuries following discharge from COVID-19 critical care who were referred to the peripheral nerve injury multidisciplinary team. Data were collected retrospectively on what peripheral neuropathies were observed, with reference to relevant investigation findings and proning history. Results During the first wave of the COVID-19 pandemic in the United Kingdom, 256 patients were admitted to COVID-19 critical care of Queen Elizabeth Hospital, Birmingham, United Kingdom. From March to June 2020, a total of 114 patients required prone ventilation. In this subgroup, a total of 15 patients were identified with clinical findings of peripheral nerve injuries within the upper limb. In total, 30 anatomical nerve injuries were recorded. The most commonly affected nerve was the ulnar nerve (12/30) followed by the cords of the brachial plexus (10/30). Neuropathic pain and muscle wasting were identified, signifying a high-grade nerve injury. Conclusion Peripheral nerve injuries can be associated with prone positioning on intensive care units, although other mechanisms, such as those of a neuroinflammatory nature, cannot be excluded. Impact Proning-related upper limb peripheral nerve injuries are not discussed widely in the literature and could be an area of further consideration when critical care units review their proning protocols. Physical therapists treating these patients play a key part in the management of this group of patients by optimizing the positioning of patients during proning, making early identification of peripheral nerve injuries, providing rehabilitation interventions, and referring to specialist services if necessary. Lay Summary During the COVID-19 pandemic, patients who are very ill can be placed for long periods of time on their stomach to improve their chances of survival. The potential consequences of prolonged time in this position are weakness and pain in the arms due to potential nerve damage. There are some recommended treatments to take care of these problems.

Peripheral Nerve Injuries of the Shoulder in the Athlete

1990 ◽  
Vol 9 (2) ◽  
pp. 331-342 ◽  
Author(s):  
Francis X. Mendoza ◽  
Kenneth Main
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

scholarly journals 375. COVID 19 infection in a Massachusetts community hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S257-S258
Author(s):  
Raul Davaro ◽  
alwyn rapose
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Essential Hypertension ◽  
Severe Acute Respiratory Syndrome ◽  
High Mortality ◽  
Case Series ◽  
World Health ◽  
Minimal Risk ◽  
The Impact

Abstract Background The ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has led to 105690 cases and 7647 deaths in Massachusetts as of June 16. Methods The study was conducted at Saint Vincent Hospital, an academic health medical center in Worcester, Massachusetts. The institutional review board approved this case series as minimal-risk research using data collected for routine clinical practice and waived the requirement for informed consent. All consecutive patients who were sufficiently medically ill to require hospital admission with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by positive result on polymerase chain reaction testing of a nasopharyngeal sample were included. Results A total of 109 consecutive patients with COVID 19 were admitted between March 15 and May 31. Sixty one percent were men, the mean age of the cohort was 67. Forty one patients (37%) were transferred from nursing homes. Twenty seven patients died (24%) and the majority of the dead patients were men (62%). Fifty one patients (46%) required admission to the medical intensive care unit and 34 necessitated mechanical ventilation, twenty two patients on mechanical ventilation died (63%). The most common co-morbidities were essential hypertension (65%), obesity (60%), diabetes (33%), chronic kidney disease (22%), morbid obesity (11%), congestive heart failure (16%) and COPD (14%). Five patients required hemodialysis. Fifty five patients received hydroxychloroquine, 24 received tocilizumab, 20 received convalescent plasma and 16 received remdesivir. COVID 19 appeared in China in late 2019 and was declared a pandemic by the World Health Organization on March 11, 2020. Our study showed a high mortality in patients requiring mechanical ventilation (43%) as opposed to those who did not (5.7%). Hypertension, diabetes and obesity were highly prevalent in this aging population. Our cohort was too small to explore the impact of treatment with remdesivir, tocilizumab or convalescent plasma. Conclusion In this cohort obesity, diabetes and essential hypertension are risk factors associated with high mortality. Patients admitted to the intensive care unit who need mechanical ventilation have a mortality approaching 50 %. Disclosures All Authors: No reported disclosures

scholarly journals Characterisation of Textile Embedded Electrodes for Use in a Neonatal Smart Mattress Electrocardiography System

Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 999
Author(s):  
Henry Dore ◽  
Rodrigo Aviles-Espinosa ◽  
Zhenhua Luo ◽  
Oana Anton ◽  
Heike Rabe ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
High Resolution ◽  
Neonatal Intensive Care Unit ◽  
Real Time ◽  
Neonatal Intensive Care ◽  
Delivery Room ◽  
Proof Of Concept ◽  
Heart Rate Monitoring

Heart rate monitoring is the predominant quantitative health indicator of a newborn in the delivery room. A rapid and accurate heart rate measurement is vital during the first minutes after birth. Clinical recommendations suggest that electrocardiogram (ECG) monitoring should be widely adopted in the neonatal intensive care unit to reduce infant mortality and improve long term health outcomes in births that require intervention. Novel non-contact electrocardiogram sensors can reduce the time from birth to heart rate reading as well as providing unobtrusive and continuous monitoring during intervention. In this work we report the design and development of a solution to provide high resolution, real time electrocardiogram data to the clinicians within the delivery room using non-contact electric potential sensors embedded in a neonatal intensive care unit mattress. A real-time high-resolution electrocardiogram acquisition solution based on a low power embedded system was developed and textile embedded electrodes were fabricated and characterised. Proof of concept tests were carried out on simulated and human cardiac signals, producing electrocardiograms suitable for the calculation of heart rate having an accuracy within ±1 beat per minute using a test ECG signal, ECG recordings from a human volunteer with a correlation coefficient of ~ 87% proved accurate beat to beat morphology reproduction of the waveform without morphological alterations and a time from application to heart rate display below 6 s. This provides evidence that flexible non-contact textile-based electrodes can be embedded in wearable devices for assisting births through heart rate monitoring and serves as a proof of concept for a complete neonate electrocardiogram monitoring system.

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