Acquired neuromuscular dysfunction in the intensive care unit

Abstract

Introduction: Polyneuropathy and myopathy, grouped under the term «intensive care unit-acquired weakness» (ICUAW), are neuromuscular pathologies to which patients in the intensive care unit (ICU) are susceptible. They are multifactorial pathologies, prolonged connection to a ventilator is one of the most common. The objective of this review was to identify the efficacy of different rehabilitative treatments in patients with ICUAW, and the relationship between ICUAW and a series of indicators.

Methods: A systematic review of the primary studies selected from the Medline, Scielo, Web of Science, Cochrane, Cuiden and Science Direct databases was carried out, following the guidelines of the PRISMA statement, by which the search protocol was established.

Results and conclusions: Of 161 articles, only 10 were selected to be part of this review, in which a total of 717 patients admitted to the ICU were studied. A statistically significant relationship was observed between ICUAW and failure in ventilator disconnection, mortality, increase in ICU stay and the time that the patients required mechanical ventilation. Moreover, all this improved in this type of patients with the application of a rehabilitation therapy. The use of corticosteroids, was not shown to be related to neuromuscular alteration.

Keywords: Artificial respiration; Corticoesteroides; Corticosteroids; Critical illness myopathy; Critical illness polyneuropathy; Desconexión del ventilador; Miopatía del paciente crítico; Mortalidad; Mortality; Polineuropatía del paciente crítico; Rehabilitación; Rehabilitation; Respiración artificial; Terapia; Therapy; Ventilator disconnection.