MUSCLE DYSFUNCTION IN THE INTENSIVE CARE UNIT - 08/09/11
Résumé |
Muscle weakness, particularly impairment of the respiratory muscles, is a common problem in intensive care unit (ICU) patients.30 In most patients, muscle weakness is the consequence of their illness. Patients who have sepsis, multiple-organ failure, and hypercapnea (acidosis) are known to develop neuromuscular abnormalities.16, 89 Muscle wasting, metabolic abnormalities, and neuromyopathic changes can all cause weakness (Table 1).
This article provides the physician with information regarding the present status of the assessment of respiratory muscles in ICU patients. The author reviews the most common abnormalities that can cause muscle weakness—mainly those associated with other medical conditions, such as sepsis, multiorgan failure, mechanical ventilation, and drugs—with special emphasis on the current concept of polyneuropathy of critical illness, myopathy, and prolonged paralysis associated with the use of neuromuscular blocking agents and corticosteroids.
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| Address reprint requests to Antonio Anzueto, MD, 111 E, VA Medical Center, 7400 Merton Minter Blvd., San Antonio, TX 78284, e-mail: anzueto@uthscsa.edu |
Vol 20 - N° 2
P. 435-452 - juin 1999 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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