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.

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.

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 Icatibant for Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema in Intubated Patients: Case Series and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Erin K. Yeung ◽  
Haritha Saikumar ◽  
Jose Castaneda-Nerio ◽  
Sandra G. Adams ◽  
Mark Wong
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Converting Enzyme Inhibitor ◽  
Enzyme Inhibitor ◽  
Case Reports ◽  
Case Series ◽  
Converting Enzyme ◽  
Converting Enzyme Inhibitor

Purpose. A case series of icatibant use in intubated patients with angiotensin-converting enzyme inhibitor- (ACEI-) induced angioedema is presented along with a relevant literature review and recommendations for utilization. Summary. Three intubated patients admitted to the intensive care unit for ACEI-induced angioedema were treated with icatibant. A literature search identified one controlled study and four case reports describing the use of icatibant in intubated ACEI-induced angioedema patients. Conclusion. Icatibant administration in intubated patients may be beneficial in decreasing time to extubation and length of intensive care unit stay. In the three cases described, icatibant administration did not appear to elicit a response in intubated patients, which has been described in previous case reports. For clinicians considering icatibant in the treatment of ACEI-induced angioedema, earlier administration upon arrival to the ED or immediately upon arriving to the intensive care unit is strongly advised. The suggested benefit of icatibant in intubated ACEI-induced angioedema patients should be verified by randomized clinical trials and cost-benefit analyses should be performed at individual institutions.

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

Transcranial Doppler in pediatric emergency and intensive care unit: a case series and literature review

2018 ◽  
Vol 34 (8) ◽  
pp. 1465-1470 ◽  
Author(s):  
Francisco Abecasis ◽  
Vitor Oliveira ◽  
Chiara Robba ◽  
Marek Czosnyka
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Literature Review ◽  
Transcranial Doppler ◽  
Case Series ◽  
Pediatric Emergency

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.

The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Hospital Discharge ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Medical Attention ◽  
Primary Role ◽  
Speech Language Pathologists ◽  
The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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
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