Muscle icu

Background/aim: Following stroke, damage to the central nervous system and adaptive changes in muscle tissue are factors responsible for the loss of muscle strength. Even though it is suggested that early physiotherapy and mobilization prevent structural adaptive changes in muscle tissue, studies regarding this issue are insufficient. The aim of this study is to investigate the effects of early physiotherapy and mobilization on quadriceps muscle thickness (QMT) in stroke patients. Materials and methods: Twelve stroke patients who were admitted to the neurology intensive care unit and 13 healthy controls were included in the study...

OBJECTIVE: To determine the sensitivity and specificity of peripheral and respiratory muscle strength tests in diagnosing critical illness polyneuromyopathy (CIPNM), compared with an electrophysiological examination. METHODS: Fifty septic patients who required mechanical ventilation for at least five days, and without a previous history of muscle weakness, were included. Peripheral muscle strength was assessed using the Medical Research Council (MRC) score, handgrip strength by dynamometry, and respiratory muscle strength with maximum respiratory pressures...

BACKGROUND: Intensive care unit-acquired weakness (ICU-AW) is associated with poorer outcome of critically ill patients. Microcirculatory changes and altered vascular permeability of skeletal muscles might contribute to the pathogenesis of ICU-AW. Muscular ultrasound (MUS) displays increased muscle echogenicity, although its pathogenesis is uncertain. OBJECTIVE: We investigated the combined measurement of serum and ultrasound markers to assess ICU-AW and clinical patient outcome...

BACKGROUND: Inspiratory muscle training (IMT) increases inspiratory muscle strength and improves quality of life in intensive care unit (ICU) patients who have been invasively mechanically ventilated for ≥7 days. The purpose of this study was to identify which patients benefit most from IMT following weaning from mechanical ventilation. METHODS: Secondary analysis of a randomized trial of supervised daily IMT in 70 patients (mean age 59 years) in a 31-bed ICU was carried out...

Background: Bed-ridden state, dysphagia, altered mental state, or respiratory muscle weakness are common in neurologic patients and increase the risk of pneumonia. The major causes of pneumonia in neurologic patients may differ from those in the general population, resulting in a different pathogen distribution. We investigated the trends of pathogen distribution in culture-positive pneumonia in hospitalized neurologic patients and the related antibiotic resistance in those with hospital-acquired pneumonia (HAP)...

BACKGROUND: In lung transplantation, preoperative sarcopenia was reported to be associated with short-term outcomes based on cross-sectional image. This study aimed to investigate the influence of psoas muscle mass (PMM) on the operative outcome and survival using three-dimensional (3D) reconstruction of PMM and to evaluate the effect of preoperative sarcopenic overweight on postoperative outcomes and survival. METHODS: A total of 107 patients who underwent double lung transplantation in one institute from January 1, 2014, to June 30, 2017, were enrolled...

BACKGROUND: Sarcopenia (a decline of skeletal muscle mass) has been identified as a predictor of poor postoperative outcomes. The impact of sarcopenia in emergency general surgery (EGS) remains undetermined. The aim of this study was to evaluate the association between sarcopenia and outcomes after EGS. METHODS: A 3-y (2012-15) review of all EGS patients aged ≥45 y was presented to our institution. Patients who underwent computer tomography-abdomen were included...

Of the various muscles that make up the respiratory system, the diaphragm is the prima donna. In the past, only specialist research centers were able to estimate and challenge the effort of this muscle; this was achieved by measuring transdiaphragmatic pressure-an invasive technique involving a double-balloon probe inserted through the esophagus-or by measuring twitch pressure (ie, the pressure generated at the outside tip of the endotracheal tube). However, the prevalence of diaphragm dysfunction in critically ill patients requiring intubation can exceed 60% (at the time of hospital admission) and may rise to as high as 80% in patients requiring prolonged mechanical ventilation and experiencing difficult weaning...

Organophosphorus (OP) compound poisoning with suicidal intent is common. It is one of the frequent cause for admission to hospital Emergencies and intensive care units in our region. We describe here a case of 19-year old girl who presented to the Emergency Department with atypical features of OP poisoning. She had perioral, tongue and lower limb fasciculations along with generalized muscle weakness with no or minimal muscarinic effects. OP poisoning with isolated nicotinic receptor mediated effect is often reported in children but in adult it is extremely rare...

Asthma is characterized by chronic airway inflammation, which is the underlying cause of airway remodeling featured by goblet cell hyperplasia, subepithelial fibrosis, and proliferation of smooth muscle. Sevoflurane has been used to treat life-threatening asthma and our previous study shows that sevoflurane inhibits acute lung inflammation in ovalbumin (OVA)-induced allergic mice. However, the effect of sevoflurane on airway remodeling in the context of chronic airway inflammation and the underlying mechanism are still unknown...

Background: Mechanically ventilated patients often develop muscle weakness post-intensive care admission. Current evidence suggests that early mobilisation of these patients can be an effective intervention in improving their outcomes. However, what constitutes early mobilisation in mechanically ventilated patients (EM-MV) remains unclear. We aimed to systematically explore the definitions and activity types of EM-MV in the literature. Methods: Whittemore and Knafl's framework guided this review...

PURPOSE: Sugammadex rapidly reverses muscle relaxation compared to acetylcholinesterase inhibitors. The long-term outcomes of sugammadex, however, are not well known. We compared 30-day postoperative outcomes following sugammadex and acetylcholinesterase inhibitor use in colorectal surgery patients. PATIENTS AND METHODS: Colorectal surgical patients older than 21 were included in this retrospective study, and were dichotomized according to use of reversal agents, sugammadex (group S), and acetylcholinesterase inhibitor (group A)...

A 12 yr old male neutered beagle was presented on transfer to the intensive care unit with severe anemia, thrombocytopenia, and bruising detected 1 day after undergoing tibial plateau leveling osteotomy surgery. The patient had undergone extra-capsular stifle stabilization surgery 14 wk prior to treat ligament disease in the same knee. Laboratory testing and treatment for anemia, presumptive immune-mediated thrombocytopenia, and possible hemostatic disorder was initiated. A persistent anemia, progressive thrombocytopenia, and the development of a firm swelling and neurologic impairment in the limb raised concerns for compartment syndrome (CS)...

Myasthenia gravis is a neuromuscular autoimmune disease characterized by fatigable weakness of skeletal muscles that results from an antibody-mediated immunological attack directed at acetylcholine postsynaptic receptors. Autologous hematopoietic stem cell transplantation is considered as a treatment option in refractory cases of myasthenia gravis. A 56-year-old Colombian male presented with six-months of progressive hoarseness and dysphagia, with a positive repetitive stimulation test suggestive of end plate neuromuscular disease...

Fast-track anesthesia (FTA) is difficult to achieve in neonates due to immature organ function and high rates of perioperative events. As a high-risk population, neonates require prolonged postoperative mechanical ventilation, which may lead to contradictions in cases where neonatal intensive care unit resources and ventilator facilities are limited. The choice of anesthesia strategy and anesthetic can help achieve rapid postoperative rehabilitation and save hospitalization costs. The authors describe their experience with maintaining spontaneous breathing in neonates undergoing anoplasty without opioids or muscle relaxants...

Intensive care unit-acquired weakness is characterised by severe impairment of muscle function that often arises after prolonged mechanical ventilation, difficult weaning, and severe sepsis. Elastic band exercises constitute an inexpensive and simple technique that is quite appealing for implementation in a "protected environment" such as the intensive care unit; however, elastic band application in the intensive care unit and in critical patients has not yet been described. A 72-year-old male was referred to the respiratory intensive care unit for hypoxemic respiratory failure due to acute respiratory distress syndrome...

INTRODUCTION: Acute muscle involvement is an infrequent complication of corticosteroids, characterized by muscle weakness and a rhabdomyolysis, rapidly regressive after withdrawal of corticosteroids. CASE REPORT: We report the case of a woman admitted in intensive care unit for acute severe asthma, treated with high doses of methylprednisolone. Serum CPK level raised with a peak at 28,160 UI/L (n<250 UI/L) at day 15, suggesting acute rhabdomyolysis with renal failure...

BACKGROUND: Mechanical ventilation (MV) causes discomfort but whether it causes pain remains controversial. Around the world neonatal intensive care units (NICU) often utilize narcotics and/or sedatives during MV of vulnerable infants yet the association with adverse neonatal outcomes has not been adequately addressed. OBJECTIVE: Test for associations between the use of narcotics/sedatives during MV and mortality/morbidity in preterm infants in a large infant cohort in Canada...

BACKGROUND: We compared the evaluation of skeletal muscle mass (SMM) using the computed tomography (CT) and bioelectrical impedance analysis (BIA) methods in critically ill patients. We also evaluated whether BIA can be applied for measuring SM with high accuracy to critically ill patients. METHODS: We included 135 critically ill surgical patients (83 men and 52 women, mean age: 59.3 years) who got the BIA and abdominal CT scan both within 7 days during the intensive care unit (ICU) stay...

INTRODUCTION: Intensive care unit-acquired weakness (ICU-AW) is often observed in critically ill patients with prolonged intensive care unit (ICU) stay. We hypothesized that evolving metabolic abnormalities during prolonged ICU stay are reflected by changing nutrient patterns in blood, urine and skeletal muscle, and that these patterns differ in patients with/without ICU-AW and between patients with/without sepsis. METHODS: In a prospective single-center observational trial, we aim to recruit 100 critically ill patients (ICU length of stay ≥ 5 days) with severe sepsis/septic shock ("sepsis group", n = 50) or severe head trauma/intracerebral hemorrhage ("CNS group", n = 50)...