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https://www.readbyqxmd.com/read/27881152/fitness-and-mobility-training-in-patients-with-intensive-care-unit-acquired-muscle-weakness-fitonicu-study-protocol-for-a-randomised-controlled-trial
#1
Jan Mehrholz, Simone Thomas, Jane H Burridge, André Schmidt, Bettina Scheffler, Ralph Schellin, Stefan Rückriem, Daniel Meißner, Katja Mehrholz, Wolfgang Sauter, Ulf Bodechtel, Bernhard Elsner
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living...
November 24, 2016: Trials
https://www.readbyqxmd.com/read/27676204/time-to-decannulation-and-associated-risk-factors-in-the-post-acute-rehabilitation-of-critically-ill-patients-with-intensive-care-unit-acquired-weakness-a-cohort-study
#2
Simone Thomas, Wolfgang Sauter, Ulrike Starrost, Marcus Pohl, Jan Mehrholz
BACKGROUND: Treatment of critical illness on intensive-care-units (ICU) results often in persistent invasive endotracheal intubation which might delay rehabilitation and increases the risk of mortality. Recent longitudinal studies have described the recovery of critically ill people, but the detailed time course of decannulation in patients with chronic critical illness with ICU- acquired muscle weakness (ICUAW) is not well known. AIM: The aim of our study was therefore to describe the decannulation times and associated risk factors in patients who are chronic critically ill with ICU acquired weakness...
September 27, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27532030/prolonged-glucocorticoid-treatment-in-ards-impact-on-intensive-care-unit-acquired-weakness
#3
REVIEW
Gianfranco Umberto Meduri, Andreas Schwingshackl, Greet Hermans
Systemic inflammation and duration of immobilization are strong independent risk factors for the development of intensive care unit-acquired weakness (ICUAW). Activation of the pro-inflammatory transcription factor nuclear factor-κB (NF-κB) results in muscle wasting during disuse-induced skeletal muscle atrophy (ICU bed rest) and septic shock. In addition, NF-κB-mediated signaling plays a significant role in mechanical ventilation-induced diaphragmatic atrophy and contractile dysfunction. Older trials investigating high dose glucocorticoid treatment reported a lack of a sustained anti-inflammatory effects and an association with ICUAW...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27411715/transcriptomic-analysis-reveals-abnormal-muscle-repair-and-remodeling-in-survivors-of-critical-illness-with-sustained-weakness
#4
Christopher J Walsh, Jane Batt, Margaret S Herridge, Sunita Mathur, Gary D Bader, Pingzhao Hu, Claudia C Dos Santos
ICU acquired weakness (ICUAW) is a common complication of critical illness characterized by structural and functional impairment of skeletal muscle. The resulting physical impairment may persist for years after ICU discharge, with few patients regaining functional independence. Elucidating molecular mechanisms underscoring sustained ICUAW is crucial to understanding outcomes linked to different morbidity trajectories as well as for the development of novel therapies. Quadriceps muscle biopsies and functional measures of muscle strength and mass were obtained at 7 days and 6 months post-ICU discharge from a cohort of ICUAW patients...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27312737/icu-acquired-weakness-a-rehabilitation-perspective-of-diagnosis-treatment-and-functional-management
#5
Richard D Zorowitz
ICU-acquired weakness (ICUAW) occurs with reported incidence rates from 25% to 100%. Risk factors include immobility, sepsis, persistent systemic inflammation, multiorgan system failure, hyperglycemia, glucocorticoids, and neuromuscular blocking agents. The pathophysiology remains unknown. Clinical features may be neuropathic, myopathic, or a combination of both. Although manual muscle testing is more practical in diagnosing ICUAW, the "gold standard" for the diagnosis of ICUAW remains electromyography and nerve conduction studies...
October 2016: Chest
https://www.readbyqxmd.com/read/27290397/randomised-controlled-trial-using-daily-electrical-muscle-stimulation-ems-in-critically-ill-patients-to-prevent-intensive-care-unit-icu-acquired-weakness-icuaw
#6
M Goll, T Wollersheim, K Haas, R Moergeli, J Malleike, F Nehls, K Reiher, N Carbon, G Sonomoya, S Weber-Carstens
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27243968/a-case-of-intensive-care-unit-acquired-weakness-after-emergency-surgery-for-acute-abdomen
#7
Tetsuro Tominaga, Takashi Nonaka, Hiroaki Takeshita, Yuichiro Honda, Hiroki Nagura, Toshio Shiraishi, Masaki Kunizaki, Yorihisa Sumida, Shigekazu Hidaka, Terumitsu Sawai, Takeshi Nagayasu
INTRODUCTION: Surgeons often perform surgery for patients who are critically ill. Intensive care unit (ICU)-acquired weakness (ICUAW) is a condition in which systemic and prolonged muscle weakness occurs and causes worse short-term and long-term outcomes. PRESENTATION OF CASE: A 60-year-old woman with sudden nausea and vomiting presented to our hospital and developed shock. Abdominal CT showed thickness of the descending colon and ascites. She was diagnosed with sepsis due to descending colon cancer...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27118372/reduced-motor-neuron-excitability-is-an-important-contributor-to-weakness-in-a-rat-model-of-sepsis
#8
Paul Nardelli, Jacob A Vincent, Randall Powers, Tim C Cope, Mark M Rich
The mechanisms by which sepsis triggers intensive care unit acquired weakness (ICUAW) remain unclear. We previously identified difficulty with motor unit recruitment in patients as a novel contributor to ICUAW. To study the mechanism underlying poor recruitment of motor units we used the rat cecal ligation and puncture model of sepsis. We identified striking dysfunction of alpha motor neurons during repetitive firing. Firing was more erratic, and often intermittent. Our data raised the possibility that reduced excitability of motor neurons was a significant contributor to weakness induced by sepsis...
August 2016: Experimental Neurology
https://www.readbyqxmd.com/read/27063347/icu-acquired-weakness
#9
REVIEW
Sarah E Jolley, Aaron E Bunnell, Catherine L Hough
Survivorship after critical illness is an increasingly important health-care concern as ICU use continues to increase while ICU mortality is decreasing. Survivors of critical illness experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay. Newfound impairment is associated with increased health-care costs and use, reductions in health-related quality of life, and prolonged unemployment. Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in patients who are critically ill, with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysfunction...
November 2016: Chest
https://www.readbyqxmd.com/read/27025938/recovery-and-outcomes-after-the-acute-respiratory-distress-syndrome-ards-in-patients-and-their-family-caregivers
#10
REVIEW
Margaret S Herridge, Marc Moss, Catherine L Hough, Ramona O Hopkins, Todd W Rice, O Joseph Bienvenu, Elie Azoulay
Outcomes after acute respiratory distress syndrome (ARDS) are similar to those of other survivors of critical illness and largely affect the nerve, muscle, and central nervous system but also include a constellation of varied physical devastations ranging from contractures and frozen joints to tooth loss and cosmesis. Compromised quality of life is related to a spectrum of impairment of physical, social, emotional, and neurocognitive function and to a much lesser extent discrete pulmonary disability. Intensive care unit-acquired weakness (ICUAW) is ubiquitous and includes contributions from both critical illness polyneuropathy and myopathy, and recovery from these lesions may be incomplete at 5 years after ICU discharge...
May 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27025126/-characteristics-of-surface-electromyography-and-acid-base-balance-in-patients-with-intensive-care-unit-acquired-weakness
#11
A Yu Mejgal, O G Tret'jakova, A P Spasova
OBJECTIVE: The study was aimed to search for correlation between parameters of surface electromyography and acid-base balance (ABB) in patients with intensive care unit-acquired weakness (ICUAW, n = 29, duration 7-180 days). METHODS: The linear and nonlinear parameters of sEMG (mean frequency of spectrum, fractal and correlation dimension, correlation entropy) and ABB and their correlation coefficient with bed rest (BR) and duration of mechanical ventilation (MT) were computed...
November 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/26976118/risk-factors-for-worsened-quality-of-life-in-patients-on-mechanical-ventilation-a-prospective-multicenter-study
#12
M Busico, D Intile, M Sívori, N Irastorza, A L Alvarez, J Quintana, L Vazquez, G Plotnikow, F Villarejo, P Desmery
OBJECTIVE: To identify risk factors for worsened quality of life (QoL) and activities of daily living (ADL) at 3 and 12 months after discharge from the Intensive Care Unit (ICU) in patients on mechanical ventilation (MV). DESIGN: A prospective, multicentric observational study was made. SETTING: Three ICUs in Argentina. PATIENTS: The study included a total of 84 out of 129 mainly clinical patients admitted between 2011-2012 and requiring over 24hours of MV...
October 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/26842898/-critical-illness-polyneuropathy-and-myopathy-as-neurological-complications-of-sepsis
#13
R Kollmar
Intensive care unit acquired weakness (ICUAW) is a frequent and severe complication of intensive care management. Within ICUAW critical illness polyneuropathy (CIP) and myopathy (CIM) can be differentiated. The major symptom of ICUAW is progressive quadriparesis, which makes weaning from the respirator more difficult, can appear early after admission to an ICU and can often be detected several months after discharge from the ICU. The pathophysiology of ICUAW is multifactorial and complex. Potential therapeutic approaches are the early and sufficient therapy of mulitorgan dysfunction, optimal control of glucose levels as well as early and intensive physiotherapy...
March 2016: Der Nervenarzt
https://www.readbyqxmd.com/read/26242743/clinical-review-intensive-care-unit-acquired-weakness
#14
REVIEW
Greet Hermans, Greet Van den Berghe
A substantial number of patients admitted to the ICU because of an acute illness, complicated surgery, severe trauma, or burn injury will develop a de novo form of muscle weakness during the ICU stay that is referred to as "intensive care unit acquired weakness" (ICUAW). This ICUAW evoked by critical illness can be due to axonal neuropathy, primary myopathy, or both. Underlying pathophysiological mechanisms comprise microvascular, electrical, metabolic, and bioenergetic alterations, interacting in a complex way and culminating in loss of muscle strength and/or muscle atrophy...
August 5, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26133937/the-sick-and-the-weak-neuropathies-myopathies-in-the-critically-ill
#15
REVIEW
O Friedrich, M B Reid, G Van den Berghe, I Vanhorebeek, G Hermans, M M Rich, L Larsson
Critical illness polyneuropathies (CIP) and myopathies (CIM) are common complications of critical illness. Several weakness syndromes are summarized under the term intensive care unit-acquired weakness (ICUAW). We propose a classification of different ICUAW forms (CIM, CIP, sepsis-induced, steroid-denervation myopathy) and pathophysiological mechanisms from clinical and animal model data. Triggers include sepsis, mechanical ventilation, muscle unloading, steroid treatment, or denervation. Some ICUAW forms require stringent diagnostic features; CIM is marked by membrane hypoexcitability, severe atrophy, preferential myosin loss, ultrastructural alterations, and inadequate autophagy activation while myopathies in pure sepsis do not reproduce marked myosin loss...
July 2015: Physiological Reviews
https://www.readbyqxmd.com/read/25715872/early-mobilization-and-recovery-in-mechanically-ventilated-patients-in-the-icu-a-bi-national-multi-centre-prospective-cohort-study
#16
MULTICENTER STUDY
Carol Hodgson, Rinaldo Bellomo, Susan Berney, Michael Bailey, Heidi Buhr, Linda Denehy, Megan Harrold, Alisa Higgins, Jeff Presneill, Manoj Saxena, Elizabeth Skinner, Paul Young, Steven Webb
INTRODUCTION: The aim of this study was to investigate current mobilization practice, strength at ICU discharge and functional recovery at 6 months among mechanically ventilated ICU patients. METHOD: This was a prospective, multi-centre, cohort study conducted in twelve ICUs in Australia and New Zealand. Patients were previously functionally independent and expected to be ventilated for >48 hours. We measured mobilization during invasive ventilation, sedation depth using the Richmond Agitation and Sedation Scale (RASS), co-interventions, duration of mechanical ventilation, ICU-acquired weakness (ICUAW) at ICU discharge, mortality at day 90, and 6-month functional recovery including return to work...
February 26, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25516419/increased-expression-of-gdf-15-may-mediate-icu-acquired-weakness-by-down-regulating-muscle-micrornas
#17
S A A Bloch, J Y Lee, T Syburra, U Rosendahl, M J D Griffiths, P R Kemp, M I Polkey
RATIONALE: The molecular mechanisms underlying the muscle atrophy of intensive care unit-acquired weakness (ICUAW) are poorly understood. We hypothesised that increased circulating and muscle growth and differentiation factor-15 (GDF-15) causes atrophy in ICUAW by changing expression of key microRNAs. OBJECTIVES: To investigate GDF-15 and microRNA expression in patients with ICUAW and to elucidate possible mechanisms by which they cause muscle atrophy in vivo and in vitro...
March 2015: Thorax
https://www.readbyqxmd.com/read/25496103/an-official-american-thoracic-society-clinical-practice-guideline-the-diagnosis-of-intensive-care-unit-acquired-weakness-in-adults
#18
Eddy Fan, Fern Cheek, Linda Chlan, Rik Gosselink, Nicholas Hart, Margaret S Herridge, Ramona O Hopkins, Catherine L Hough, John P Kress, Nicola Latronico, Marc Moss, Dale M Needham, Mark M Rich, Robert D Stevens, Kevin C Wilson, Chris Winkelman, Doug W Zochodne, Naeem A Ali
RATIONALE: Profound muscle weakness during and after critical illness is termed intensive care unit-acquired weakness (ICUAW). OBJECTIVES: To develop diagnostic recommendations for ICUAW. METHODS: A multidisciplinary expert committee generated diagnostic questions. A systematic review was performed, and recommendations were developed using the Grading, Recommendations, Assessment, Development, and Evaluation (GRADE) approach. MEASUREMENT AND MAIN RESULTS: Severe sepsis, difficult ventilator liberation, and prolonged mechanical ventilation are associated with ICUAW...
December 15, 2014: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/25453427/muscle-wasting-and-early-mobilization-in-acute-respiratory-distress-syndrome
#19
REVIEW
Christopher J Walsh, Jane Batt, Margaret S Herridge, Claudia C Dos Santos
Survivors of acute respiratory distress syndrome often sustain muscle wasting and functional impairment related to intensive care unit (ICU)-acquired weakness (ICUAW) and this disability may persist for years after ICU discharge. Early diagnosis in cooperative patients by physical examination is recommended to identify patients at risk for weaning failure and to minimize prolongation of risk factors for ICUAW. When possible, early rehabilitation in critically ill patients improves functional outcomes, likely by reducing disuse atrophy...
December 2014: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/25263070/the-e3-ubiquitin-ligase-trim62-and-inflammation-induced-skeletal-muscle-atrophy
#20
Franziska Schmidt, Melanie Kny, Xiaoxi Zhu, Tobias Wollersheim, Kathleen Persicke, Claudia Langhans, Doerte Lodka, Christian Kleber, Steffen Weber-Carstens, Jens Fielitz
INTRODUCTION: ICU-acquired weakness (ICUAW) complicates the disease course of critically ill patients. Inflammation and acute-phase response occur directly within myocytes and contribute to ICUAW. We observed that tripartite motif-containing 62 (TRIM62), an E3 ubiquitin ligase and modifier of inflammation, is increased in the skeletal muscle of ICUAW patients. We investigated the regulation and function of muscular TRIM62 in critical illness. METHODS: Twenty-six critically ill patients with Sequential Organ Failure Assessment scores ≥8 underwent two skeletal muscle biopsies from the vastus lateralis at median days 5 and 15 in the ICU...
September 29, 2014: Critical Care: the Official Journal of the Critical Care Forum
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