Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.23/492
Título: Fraqueza Muscular Adquirida nos Cuidados Intensivos: Sub ou Sobrediagnosticada?
Outros títulos: Intensive Care Unit Acquired Weakness: Under or Overdiagnosed?
Autor: Morgado, S
Moura, S
Palavras-chave: Fraqueza Muscular
Miopatia
Polineuropatia
Doença Crítica
Unidade de Cuidados Intensivos
Data: 2010
Editora: Sociedade Portuguesa de Medicina Física e Reabilitação
Citação: Rev Soc Port Med Fis Reabil. 2010; 19(2): 38-44
Resumo: Intensive care unit-acquired weakness (ICU-AW) is recognized as an important and common clinical problem, associated with an increased morbidity in critical ill patients. This muscle weakness has been described in a wide range of clinical settings and therefore, has many different terminologies such as “critical illness myopathy – CIM”, “critical illness polyneuropathy - CIP”, “acute quadriplegic myopathy”, among others. Nowadays, these designations are considered somewhat restrictive, therefore most authors adopt the more wide range designation of “ICU-Acquired Weakness”.Generally, these patients have a flacid tetraparesis without cranial nerve palsy, normal or diminished osteotendinous reflexes and no sensitive alterations unless on the cases traditionally classified as polyneuropathy. The diagnosis of ICU-AW is often difficult, and should be suspected whenever a critical ill patient has unexplained weakness. Traditionally, the diagnosis of neuromuscular diseases is based in nerve conduction studies and electromyography. Muscle biopsy can be used to confirm or exclude myopathy, but is not a routine exam. Since there is a significant percentage of critical patients that develop muscle weakness it is important to screen all patients in the ICU, avoid potential toxic re-exposures on the identified patients and begin early rehabilitation. However, two questions arise from this screening: if the screening is only clinical are we underestimating these patients? If electrophysiological are we overestimating ICU-AW? There are no specific therapies for ICU-AW. The criterious use of some drugs is one of the possible measures to be taken. On the other hand, the early inclusion of these patients in a rehabilitation program seems to be helpful for a speedy functional recovery. There are few studies regarding ICU-AW, and systematic studies with longer follow-ups and bigger samples are necessary to determine the most effective rehabilitation approach for these patients.
Peer review: yes
URI: http://comum.rcaap.pt/handle/123456789/4662
http://hdl.handle.net/10400.23/492
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