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KMID : 0860920130150020064
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Journal of the Korean Association EMG-Electrodiagnostic Medicine
2013 Volume.15 No. 2 p.64 ~ p.72
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Intensive Care Unit-acquired Weakness
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Kwon Ki-Han
Minn Yang-Ki
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Abstract
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Intensive care unit-acquired weakness (ICUAW) is common in patients with critical illness. Critical illness neuropathy (CIN), critical illness myopathy (CIM), and critical illness neuromyopathy (CINM) are the main parts of ICUAW. It is associated with delayed weaning from ventilation, delayed discharge from intensive care unit (ICU) and hospital, and increased in-hospital mortality. It also causes chronic disabilities in survivors. But it is hard to diagnose because of various patients’ conditions. Endotracheal intubation, sedation or coexistent encephalopathy, neuromuscular blockade, and electrical equipments in ICU prevent careful examination. And other neuromuscular diseases can also mimic ICUAW. Muscle excitability loss, muscle atrophy, loss of myosin and neuropathy are mainly involved in its pathogenesis. Main risk factors which are related with ICUAW are sepsis, multiorgan failure, hyperglycemia. Steroids, neuromuscular blocking agents, and immobility, which are controversial are also thought as risk factors.
I would like to review the pathogenesis, clinical features, and diagnostic criteria of each of ICUAW.
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KEYWORD
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intensive care unit-acquired weakness, pathogenesis, diagnostic criteria
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