Early evaluation of ICU-acquired Weakness with systematic nerve conduction study in septic shock patients ventilated longer than 72 hours

Details

Ressource 1 Sous embargo indéterminé.
State: Public
Version: After imprimatur
License: Not specified
Serval ID
serval:BIB_19089386168F
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
Early evaluation of ICU-acquired Weakness with systematic nerve conduction study in septic shock patients ventilated longer than 72 hours
Author(s)
SAUTEREL L.
Director(s)
DISERENS K.
Codirector(s)
PIQUILLOUD IMBODEN L.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2019
Language
english
Number of pages
17
Abstract
Background: Sepsis and multiple organ failure are associated with severe complications in patients admitted at Intensive Care Unit (ICU) especially Critical Illness Polyneuropathy (CIP) and Myopathy (CIM). Those are associated with immobilization and known to increase mechanical ventilation duration, length of stay and risk of death. Early screening with motor peroneal nerve test (PENT) and sensory sural nerve test may be useful screening tools to recognize these neuromuscular complications. Aim: To record peroneal nerve test (PENT) and sensory sural nerve action potentials (SNAP) in patients suffering from septic shock and undergoing mechanical ventilation for more than 72 hours and to evaluate risk factors to develop these conditions. Design: Observational study. Method: PENT screening was performed after 72 hours of intubation and repeated until pathological response was detected. SNAP was tested on sural nerve in patients with pathological PENT to differentiate CIP from CIM. Clinical muscle strength examination was performed as patients awoke. Time to first in bed and out of bed mobilization was also recorded. Results: 20 patients were initially included. Two withdrew their consent. 18 patients underwent PENT testing between day 3 and day 7 with mechanical ventilation. Mean time elapsed between intubation and first intervention protocol was of 94.38 (+ 22.41) hours. 7 patients (38.9%) had CIP, 2 patients (11.1%) had CIM, 1 patient (5.6%) had CIP and CIM, 6 patients (33.3%) had pathological response associated with CIP or CIM, 2 patients (11.1%) had no peripheral deficit. CIP and CIM were therefore present in 55.6% to 88.9% of septic patients with mechanical ventilation. When tested, clinical muscle strength examination confirmed electrophysiological finding. 13 patients (72.2%) received out of bed mobilization with an average time of 10 (+ 7.54) days after admission. Conclusion: CIP and CIM are highly frequent in septic patients and can be recognized before being symptomatic.
Keywords
Critical care illness, nerve conduction study, care induced neuropathy, care induced myopathy, early mobilization
Create date
07/09/2020 12:56
Last modification date
09/02/2021 6:26
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