II. Risk Factors: Impacts mobility and stair climbing after ICU admit

  1. Prolonged ICU Stay
  2. Poor baseline health status
  3. Longer duration of Mechanical Ventilation

III. Pathophysiology

  1. Similar pathophysiology to Critical Illness Polyneuropathy
  2. Muscular deconditioning due to prolonged immobilization
  3. Myosin to Actin ratio reduced
  4. Lean Body Mass drops 2% per day with prolonged immobilization

IV. Diagnosis

  1. Similar diagnostic criteria for Critical Illness Polyneuropathy
  2. Limb Weakness AND
  3. Unexplained difficult mechanical Ventilator Weaning

V. Diagnostics

  1. Distinguish from Critical Illness Polyneuropathy
    1. Electromyography
    2. Nerve Conduction Velocity Studies
  2. Distinguish from other Myopathy
    1. Muscle Biopsy

VI. Management

  1. Physical Rehabilitation
    1. Contrast with Critical Illness Polyneuropathy in which physical therapy has no evidence of benefit
  2. Graded Exercise program
    1. Early mobilization is key

VII. Course

  1. Complications associated with deconditioning can persist 12 months after ICU admission

Images: Related links to external sites (from Bing)

Related Studies