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Critical Care
Published in: Critical Care 1/2018

Open Access 01-12-2018 | Viewpoint

ICU-acquired weakness: should medical sovereignty belong to any specialist?

Author: Domenico Intiso

Published in: Critical Care | Issue 1/2018

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Abstract

ICU-acquired weakness (ICUAW), including critical illness polyneuropathy, critical illness myopathy, and critical illness polyneuropathy and myopathy, is a frequent disabling disorder in ICU subjects. Research has predominantly been performed by intensivists, whose efforts have permitted the diagnosis of ICUAW early during an ICU stay and understanding of several of the pathophysiological and clinical aspects of this disorder. Despite important progress, the therapeutic strategies are unsatisfactory and issues such as functional outcomes and long-term recovery remain unclear. Studies involving multiple specialists should be planned to better differentiate the ICUAW types and provide proper functional outcome measures and follow-up. A more strict collaboration among specialists interested in ICUAW, in particular physiatrists, is desirable to plan proper care pathways after ICU discharge and to better meet the health needs of subjects with ICUAW.
Literature
1.
Stevens RD, Marshall SA, Cornblath DR, Hoke A, Needham DM, de Jonghe B, Ali NA, Sharshar T. A framework for diagnosing and classifying intensive care unit-acquired weakness. Crit Care Med. 2009;37(10 Suppl):S299–308.CrossRefPubMed
2.
3.
Lefaucheur JP, Nordine T, Rodriguez P, Brochard L. Origin of ICU acquired paresis determined by direct muscle stimulation. J Neurol Neurosurg Psychiatry. 2006;77(4):500–6.CrossRefPubMed
4.
Kerbaul F, Brousse M, Collart F, et al. Combination of histopathological and electromyographic patterns can help to evaluate functional outcome of critical ill patients with neuromuscular weakness syndromes. Crit Care. 2004;8(6):416–8.CrossRef
5.
Li N, Liu Z, Wang G, Wang S. Downregulation of the sodium channel Nav1.6 by potential transcriptomic deregulation may explain sensory deficits in critical illness neuropathy. Life Sci. 2015;143:231–6.CrossRefPubMed
6.
Llano-Diez M, Cheng AJ, Jonsson W, Ivarsson N, Westerblad H, Sun V, Cacciani N, Larsson L, Bruton J. Impaired Ca(2+) release contributes to muscle weakness in a rat model of critical illness myopathy. Crit Care. 2016;20(1):254.CrossRefPubMedPubMedCentral
7.
8.
Rich MM, Teener JW, Raps EC, Schotland DL, Bird SJ. Muscle is electrically inexcitable in acute quadriplegic myopathy. Neurology. 1996;46:731–6.CrossRefPubMed
9.
Latronico N, Herridge M, Hopkins RO, Angus D, Hart N, Hermans G, Iwashyna T, Arabi Y, Citerio G, Wesley Ely E, Hall J, Mehta S, Puntillo K, Van den Hoeven J, Wunsch H, Cook D, Dos Santos C, Rubenfeld G, Vincent JL, Van den Berghe G, Azoulay E, Needham DM. The ICM research agenda on intensive care unit-acquired weakness. Intensive Care Med. 2017;43(9):1270–81.https://​doi.​org/​10.​1007/​s00134-017-4757-5.
10.
Hermans G, De Jonghe B, Bruyninckx F, Van den Berghe G. Interventions for preventing critical illness polyneuropathy and critical illness myopathy. Cochrane Database Syst Rev. 2014;1:CD006832.
11.
Brummel NE, Balas MC, Morandi A, Ferrante LE, Gill TM, Ely EW. Understanding and reducing disability in older adults following critical illness. Crit Care Med. 2015;43(6):1265–75.CrossRefPubMedPubMedCentral
12.
Koch S, Wollersheim T, Bierbrauer J, Haas K, Mörgeli R, Deja M, Spies CD, Spuler S, Krebs M, Weber-Carstens S. Long-term recovery in critical illness myopathy is complete, contrary to polyneuropathy. Muscle Nerve. 2014;50(3):431–6.CrossRefPubMed
13.
Guarneri B, Bertolini G, Latronico N. Long-term outcome in patients with critical illness myopathy or neuropathy: the Italian multicentre CRIMYNE study. J Neurol Neurosurg Psychiatry. 2008;79(7):838–41.CrossRefPubMed
14.
Rich MM, Bird SJ, Raps EC, McCluskey LF, Teener JW. Direct muscle stimulation in acute quadriplegic myopathy. Muscle Nerve. 1997;20:665–73.CrossRefPubMed
15.
Marrero HG, Stålberg EV. Optimizing testing methods and collection of reference data for differentiating critical illness polyneuropathy from critical illness myopathies. Muscle Nerve. 2016;53(4):555–63.CrossRefPubMed
16.
Latronico N, Shehu I, Seghelini E. Neuromuscular sequelae of critical illness. Curr Opin Crit Care. 2005;11(4):381–90.CrossRefPubMed
17.
Zifko UA. Long-term outcome of critical illness polyneuropathy. Muscle Nerve Suppl. 2000;9:S49–52.CrossRefPubMed
18.
De Jonghe B, Sharshar T, Lefaucheur JP, Authier FJ, Durand-Zaleski I, Boussarsar M, Cerf C, Renaud E, Mesrati F, Carlet J, Raphaël JC, Outin H, Bastuji-Garin S. Paresis acquired in the intensive care unit: a prospective multicentre study. JAMA. 2002;288(22):2859–67.CrossRefPubMed
19.
Van den Berghe G, Schoonheydt K, Becx P, Bruyninckx F, Wouters PJ. Insulin therapy protects the central and peripheral nervous system of intensive care patients. Neurology. 2005;64(8):1348–53.CrossRefPubMed
20.
21.
Intiso D, Amoruso L, Zarrelli M, Pazienza L, Basciani M, Grimaldi G, Iarossi A, Di Rienzo F. Long-term functional outcome and health status of patients with critical illness polyneuromyopathy. Acta Neurol Scand. 2011;123(3):211–9.CrossRefPubMed
22.
Bagnato S, Boccagni C, Sant’angelo A, Prestandrea C, Romano MC, Galardi G. Neuromuscular involvement in vegetative and minimally conscious states following acute brain injury. J Peripher Nerv Syst. 2011;16(4):315–21.CrossRefPubMed
23.
Porta R, Vitacca M, Gile LS, Clini E, Bianchi L, Zanotti E, et al. Supported arm training in patients recently weaned from mechanical ventilation. Chest. 2005;128(4):2511–20.CrossRefPubMed
24.
Salisbury L, Merriweather J, Walsh T. The development and feasibility of a ward-based physiotherapy and nutritional rehabilitation package for people experiencing critical illness. Clin Rehabil. 2010;24:489–500.CrossRefPubMed
25.
Elliott D, McKinley S, Alison J, Aitken LM, King M, Leslie GD, Kenny P, Taylor P, Foley R, Burmeister E. Health-related quality of life and physical recovery after a critical illness: a multi-centre randomised controlled trial of a home-based physical rehabilitation program. Crit Care. 2011;15(3):R142.CrossRefPubMedPubMedCentral
26.
Ferrante LE, Pisani MA, Murphy TE, Gahbauer EA, Leo-Summers LS, Gill TM. Functional trajectories among older persons before and after critical illness. JAMA Intern Med. 2015;175(4):523–9.CrossRefPubMedPubMedCentral
27.
Mehrholz J, Pohl M, Kugler J, Burridge J, Mückel S, Elsner B. Physical rehabilitation for critical illness myopathy and neuropathy. Cochrane Database Syst Rev. 2015;3:CD010942.
28.
Novak Novak P, Vidmar G, Kuret Z, Bizovičar N. Rehabilitation of critical illness polyneuropathy and myopathy patients: an observational study. Int J Rehabil Res. 2011;34(4):336–42.CrossRefPubMed
29.
Latronico N. Critical illness polyneuropathy and myopathy 20 years later. No man’s land? No, it is our land! Intensive Care Med. 2016;42(11):1790–3.CrossRefPubMed
30.
Latronico N, Nattino G, Guarneri B, Fagoni N, Amantini A, Bertolini G; GiVITI Study Investigators. Validation of the peroneal nerve test to diagnose critical illness polyneuropathy and myopathy in the intensive care unit: the multicentre Italian CRIMYNE-2 diagnostic accuracy study. Version 3. F1000Res. 2014 Jun 11 [revised 2014 Jul 21];3:127. https://​doi.​org/​10.​12688/​f1000research.​3933.​3.
31.
Puthucheary ZA, Phadke R, Rawal J, McPhail MJ, Sidhu PS, Rowlerson A, Moxham J, Harridge S, Hart N, Montgomery HE. Qualitative ultrasound in acute critical illness muscle wasting. Crit Care Med. 2015;43(8):1603–11.CrossRefPubMed
32.
Parry SM, El-Ansary D, Cartwright MS, Sarwal A, Berney S, Koopman R, Annoni R, Puthucheary Z, Gordon IR, Morris PE, Denehy L. Ultrasonography in the intensive care setting can be used to detect changes in the quality and quantity of muscle and is related to muscle strength and function. J Crit Care. 2015;30(5):1151.e9–14.CrossRef
33.
Witteveen E, Sommers J, Wieske L, Doorduin J, van Alfen N, Schultz MJ, van Schaik IN, Horn J, Verhamme C. Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study. Ann Intensive Care. 2017;7(1):40.CrossRefPubMedPubMedCentral
34.
Major ME, Kwakman R, Kho ME, Connolly B, McWilliams D, Denehy L, Hanekom S, Patman S, Gosselink R, Jones C, Nollet F, Needham DM, Engelbert RH, van der Schaaf M. Surviving critical illness: what is next? An expert consensus statement on physical rehabilitation after hospital discharge. Crit Care. 2016;20(1):354.CrossRefPubMedPubMedCentral
Metadata
Title
ICU-acquired weakness: should medical sovereignty belong to any specialist?
Author
Domenico Intiso
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2018
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-017-1923-7

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