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A guided approach to diagnose severe muscle weakness in the intensive care unit.

Latronico N, Gosselink R - Rev Bras Ter Intensiva (2015)

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, Critical Care Medicine and Emergency, Spedali Civili University Hospital, Brescia, IT.

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Intensive care unit (ICU) acquired muscle weakness (ICUAW) is a clinically detected A diagnosis of ICUAW is achieved by manually testing the muscle strength using the Medical Recently, a simplified version of the scale with only four categories and improved clinimetric properties was proposed (Figure 2)... version has been validated in a small cohort of 60 critically ill patients with excellent inter-rater reliability and high sensitivity and specificity in diagnosing ICUAW compared However, voluntary muscle strength using the MRC Common causes of ICUAW include critical illness polyneuropathy (CIP) and myopathy (CIM), performed in 10 minutes... A reduced ICUAW is a clinically relevant complication during the acute stage of disease and after In conclusion, muscle weakness acquired during the ICU stay is a clinically relevant complication with an impact on early and late outcome... for patients, and pragmatic diagnostic flow-charts, as proposed here, may be of help in daily practice.

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Diagnostic algorithm for intensive care unit acquired muscle weakness (ICUAW).Modified from: Latronico N, Bolton CF. Critical illness polyneuropathy and myopathy:a major cause of muscle weakness and paralysis. Lancet Neurol.2011;10(10):931-41.(1)Cut-off handgrip strength values were below 7kg for female and below 11Kg for males.DD - differential diagnosis; NCS - nerve conduction study; EMG - electromyography; NM- neuromuscular; CIP - critical illness polyneuropathy; CIM - critical illnessmyopathy; MRC - Medical Research Council; CMAP - compound muscle actionpotential.
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f01: Diagnostic algorithm for intensive care unit acquired muscle weakness (ICUAW).Modified from: Latronico N, Bolton CF. Critical illness polyneuropathy and myopathy:a major cause of muscle weakness and paralysis. Lancet Neurol.2011;10(10):931-41.(1)Cut-off handgrip strength values were below 7kg for female and below 11Kg for males.DD - differential diagnosis; NCS - nerve conduction study; EMG - electromyography; NM- neuromuscular; CIP - critical illness polyneuropathy; CIM - critical illnessmyopathy; MRC - Medical Research Council; CMAP - compound muscle actionpotential.

Mentions: Intensive care unit (ICU) acquired muscle weakness (ICUAW) is a clinically detectedcondition characterized by diffuse, symmetric weakness involving the limbs and respiratorymuscles.(1) Patients have differentdegrees of limb muscle weakness and are dependent on a ventilator, while the facial musclesare spared. Diagnosis of ICUAW requires that no plausible etiology other than criticalillness be identified, and thus, other causes of acute muscle weakness are excluded. Onemajor diagnostic criterion is that ICUAW is detected after the onset of critical illness;therefore, it is important to differentiate ICUAW from Guillain-Barrè syndrome orother acute neuromuscular disorders that may cause respiratory failure and ICU admission(Figure 1).(1) The use of neuromuscular blocking agents for long periods of time,the use of some antibiotics and electrolyte abnormalities, such as hypermagnesemia,hypokalemia, hypercalcemia, and hypophosphatemia, and prolonged immobilization are commonin the ICU and should be appropriately treated before a diagnosis of ICUAW isposed.(2)


A guided approach to diagnose severe muscle weakness in the intensive care unit.

Latronico N, Gosselink R - Rev Bras Ter Intensiva (2015)

Diagnostic algorithm for intensive care unit acquired muscle weakness (ICUAW).Modified from: Latronico N, Bolton CF. Critical illness polyneuropathy and myopathy:a major cause of muscle weakness and paralysis. Lancet Neurol.2011;10(10):931-41.(1)Cut-off handgrip strength values were below 7kg for female and below 11Kg for males.DD - differential diagnosis; NCS - nerve conduction study; EMG - electromyography; NM- neuromuscular; CIP - critical illness polyneuropathy; CIM - critical illnessmyopathy; MRC - Medical Research Council; CMAP - compound muscle actionpotential.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4592111&req=5

f01: Diagnostic algorithm for intensive care unit acquired muscle weakness (ICUAW).Modified from: Latronico N, Bolton CF. Critical illness polyneuropathy and myopathy:a major cause of muscle weakness and paralysis. Lancet Neurol.2011;10(10):931-41.(1)Cut-off handgrip strength values were below 7kg for female and below 11Kg for males.DD - differential diagnosis; NCS - nerve conduction study; EMG - electromyography; NM- neuromuscular; CIP - critical illness polyneuropathy; CIM - critical illnessmyopathy; MRC - Medical Research Council; CMAP - compound muscle actionpotential.
Mentions: Intensive care unit (ICU) acquired muscle weakness (ICUAW) is a clinically detectedcondition characterized by diffuse, symmetric weakness involving the limbs and respiratorymuscles.(1) Patients have differentdegrees of limb muscle weakness and are dependent on a ventilator, while the facial musclesare spared. Diagnosis of ICUAW requires that no plausible etiology other than criticalillness be identified, and thus, other causes of acute muscle weakness are excluded. Onemajor diagnostic criterion is that ICUAW is detected after the onset of critical illness;therefore, it is important to differentiate ICUAW from Guillain-Barrè syndrome orother acute neuromuscular disorders that may cause respiratory failure and ICU admission(Figure 1).(1) The use of neuromuscular blocking agents for long periods of time,the use of some antibiotics and electrolyte abnormalities, such as hypermagnesemia,hypokalemia, hypercalcemia, and hypophosphatemia, and prolonged immobilization are commonin the ICU and should be appropriately treated before a diagnosis of ICUAW isposed.(2)

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesia, Critical Care Medicine and Emergency, Spedali Civili University Hospital, Brescia, IT.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Intensive care unit (ICU) acquired muscle weakness (ICUAW) is a clinically detected A diagnosis of ICUAW is achieved by manually testing the muscle strength using the Medical Recently, a simplified version of the scale with only four categories and improved clinimetric properties was proposed (Figure 2)... version has been validated in a small cohort of 60 critically ill patients with excellent inter-rater reliability and high sensitivity and specificity in diagnosing ICUAW compared However, voluntary muscle strength using the MRC Common causes of ICUAW include critical illness polyneuropathy (CIP) and myopathy (CIM), performed in 10 minutes... A reduced ICUAW is a clinically relevant complication during the acute stage of disease and after In conclusion, muscle weakness acquired during the ICU stay is a clinically relevant complication with an impact on early and late outcome... for patients, and pragmatic diagnostic flow-charts, as proposed here, may be of help in daily practice.

No MeSH data available.


Related in: MedlinePlus