Intro to the ICU Flashcards
3 hallmark features of ICU-Acquired weakness
- Diffuse, symmetric, flaccid muscle weakness
- Limb and respiratory mm especially affected
- DTRs may be lost or diminished
T/F ICU Acquired weakness can last months to years after hospitilization.
True
2 multi-variable predictors of muscle wasting:
- Increased age
- Days on ventilator
3 types of ICU-AW:
- Critical illness polyneuropathy (CIP)
- Critical illness myopathy (CIM)
- Prolonged NMJ Blockade
Identify the type of ICU-AW:
Usually sensory AND motor nerves involved.
Critical illness polyneuropathy (CIP)
Identify the type of ICU-AW:
Diffuse flaccid weakness in all limbs
Critical illness myopathy (CIM)
In which type of ICU-AW is sensation typically intact?
CIM
Which type of ICU-AW has a worse outcome? CIM or CIP?
CIP
The only evidence for treatment of ICU-AW is _________.
To prevent it from happening in the first place!
3 ways to diagnose ICU-AW
- Handheld dynamometry
- Medical research council (MRC) score
- Muscle EMG testing
What other outcome measure is included in the Medical Research Council score?
RASS
UE muscles tested in the MRC:
Deltoids, biceps, wrist extensors
LE muscles tested in the MRC:
Iliopsoas, quads, tibialis anterior
T/F the MRC will indicate whether ICU-AW is CIP or CIM.
False, doesn’t differentiate well because there’s no sensory component.
