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Intensive Care Medicine

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01-01-2009 | Brief Report

Severe weakness complicating status asthmaticus despite minimal duration of neuromuscular paralysis

Authors: Sarah M. Kesler, Mark D. Sprenkle, William S. David, James W. Leatherman

Published in: Intensive Care Medicine | Issue 1/2009

Abstract

Objective

Mechanically ventilated patients with status asthmaticus who undergo prolonged paralysis are at risk for severe weakness due to myopathy. In the mid-1990s, we changed our usual method of achieving tolerance of ventilatory support in asthmatic patients from continuous paralysis to deep sedation. This study examines the impact of this change in practice on the development of clinically significant weakness in status asthmaticus.

Design and setting

Retrospective cohort study in university-affiliated county hospital.

Patients

Mechanically ventilated asthmatic patients seen before (n = 96) and after (n = 74) a clinical practice change in 1995 that markedly restricted use of paralytics.

Results

The duration of neuromuscular paralysis declined sharply after 1995 (23.7 ± 42.2 vs. 1.8 ± 4.0 h, P < 0.001), but this was not associated with a significant difference in the incidence of weakness (21 vs. 14%, P = 0.23). Within the post-1995 cohort, there was no significant difference in the duration of paralysis for weak and non-weak patients (3.5 ± 6.2 vs. 1.5 ± 3.5 h, P = 0.10). However, weak patients had a much longer duration of mechanical ventilation than did patients without weakness (11.9 ± 3.6 vs. 1.9 ± 1.8 days, P < 0.001).

Conclusion

Mechanically ventilated patients with status asthmaticus who are immobilized for prolonged periods of time by deep sedation remain at risk for clinically significant weakness.

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Title: Severe weakness complicating status asthmaticus despite minimal duration of neuromuscular paralysis
Authors: Sarah M. Kesler
Mark D. Sprenkle
William S. David
James W. Leatherman
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 1/2009
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1267-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Severe weakness complicating status asthmaticus despite minimal duration of neuromuscular paralysis

Abstract

Objective

Design and setting

Patients

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design and setting

Patients

Results

Conclusion

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