CCP Podcast 012: Get my feet to the floor…please!

 October 16

by Jonathan Downham

ICU acquired weakness or polyneuropathy

An interview with Dr John Kress, an ITU physician from the University of Chicago. Dr Kress is a highly respected and well published doctor with an interest in ICU acquired weakness or polyneuropathy, one of his more well known papers being ” Daily Interruption of Sedative Infusions in Critically Ill Patients Undergoing Mechanical Ventilation” which discussed the use of sedation breaks in the critically ill patients in intensive care.

ICU-Acquired Weakness and recovery from Critical Illness. N Engl J Med 370;17 nejm.org april 24, 2014

kress

Dr Kress very kindly agreed to help me understand some of the principles involved in this paper.

This article discusses the effects ICU acquired weakness or polyneuropathy can have on the recovery of the patient and some of the causes of it. It then goes onto to describe some of the simple approaches the nurse and medical staff can take to help the patient recover form this debilitating condition.

Early mobilisation of the patient was one of the main principles and this is highlighted in one of his other papers “Sedation and Mobility- Changing the Paradigm” – even having patients who could stand up and walk whilst still intubated and on the ventilator.

Minimising sedation is another way to improve the patients progress in the intensive care unit and Dr Kress wrote an editorial on this topic clarifying some of the thinking; “The Changing Landscape of ICU Sedation“.

Analgesic first approach is another way to hopefully PulmCCMhelp the patient move their intensive care stay forward and PulmCCM has done a good review on this subject which I would recommend you read.

If you have any experience of any of the issues raised then please get in touch…I would love to talk.

Medical Research Council grading scale for strength of muscle groups

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