• Tuberculosis and Respiratory Diseases
• /
• v.87 no.2
• /
• pp.115-122
• /
• 2024

Post-intensive care unit (ICU) syndrome may occur after ICU treatment and includes ICU-acquired weakness (ICU-AW), cognitive decline, and mental problems. ICU-AW is muscle weakness in patients treated in the ICU and is affected by the period of mechanical ventilation. Diaphragmatic weakness may also occur because of respiratory muscle unloading using mechanical ventilators. ICU-AW is an independent predictor of mortality and is associated with longer duration of mechanical ventilation and hospital stay. Diaphragm weakness is also associated with poor outcomes. Therefore, pulmonary rehabilitation with early mobilization and respiratory muscle training is necessary in the ICU after appropriate patient screening and evaluation and can improve ICU-related muscle weakness and functional deterioration.

• Journal of Korean Critical Care Nursing
• /
• v.9 no.2
• /
• pp.13-25
• /
• 2016

Purpose: This study was conducted to identify changes in limb circumferences among patients admitted to the intensive care unit (ICU) and related factors. Methods: We conducted a prospective observational study with 27 patients from 3 ICUs at a university hospital located in B city of Korea, from September 1 to October 30, 2015. The circumferences of the left and right upper arms, thighs, and lower legs were measured on the first, third, fifth, and seventh days of ICU admission. Information on the related factors was collected from the medical records. The data were analyzed using a linear mixed model method. Results: The limbs circumferences significantly reduced from day 3, and the changes continued till day 7. These changes were related to the gender of the subjects, restraints application, use of steroids, and continuous renal replacement therapy. Conclusions: Based on the above results, it can be concluded that ICU-acquired weakness begins before the third day of admission. Thus, early mobilization protocols for ICU patients need to be developed and implemented in order to improve long-term outcomes.

• Annals of Clinical Neurophysiology
• /
• v.3 no.2
• /
• pp.115-121
• /
• 2001

The occurrence of muscle weakness in patients with sepsis or multiple organ failure managed in the intensive care unit has been recognized with increasing frequency in the last two decades. The difficulty in examining critically ill patients may explain why this complication has been only recently recognized. This weakness is due to an axonal polyneuropathy which is called critical illness polyneuropathy(CIP). It must be differentiated from myopathy or neuromuscular junction disturbance that can also occur in the intensive care setting. Neither the cause nor the exact mechanism of CIP has been elucidated. Electrophysiological studies demonstrated an acute axonal damage of the peripheral nerves. Before the recognition of CIP, these cases were usually misdiagnosed as Guillain-$Barr{\acute{e}}$ syndrome. Clinical recovery from the neuropathy is rapid and nearly complete in those patients who survive. Thus, neuropathy acquired during critical illness, although causing a delayed in weaning from ventilatory support and hospital discharge, does not worsen long-term prognosis.

• Annals of Clinical Neurophysiology
• /
• v.4 no.2
• /
• pp.91-97
• /
• 2002

The field of critical care medicine has flourished, but an unfortunate result of improved patient survival in the intensive care unit is the occurrence of certain acquired neuromuscular disorders. During the last two decades, various neuromuscular disorders were recognized as common causes of weakness occurring in critically ill patients. The two most common disorders are an acute quadriplegic myopathy predominantly associated with the use of intravenous corticosteroids and neuromuscular junction blocking agents and severe systemic illness termed critical illness myopathy(CIM), and an axonal sensorimotor polyneuropathy termed critical illness polyneuropathy. I will review briefly about general components of the CIM.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.2
• /
• pp.117-123
• /
• 2012

Optimal level of sedation and analgesia is important for the comfort and safety of critically ill patients. However, suboptimal sedation is relatively common in the intensive care unit (ICU) and it could cause prolonged mechanical ventilation and ICU stay, also increase delirium and ICU acquired weakness and resultant decreased survival. Therefore, accurate assessment of the level of sedation and analgesia, maintaining adequate level of sedation, and daily evaluation of each patient and following adjustment could be important treatment strategy in critically ill patients. Recently, the strategy for sedation in the ICU is changing toward the direction of lowering sedation level or even "no sedation" with concurrent use of analgesics and the use of ultra short acting analgesics could be helpful in some patients. Clinicians should be aware of the importance of algorithmic approach including daily interruption of sedative and assessment of sedation level and especially in the patients under mechanical ventilation, organizational approaches such as the 'ABCDE' bundle could improve the management of critically ill patients.