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Related Experiment Video

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Manual Muscle Testing: A Method of Measuring Extremity Muscle Strength Applied to Critically Ill Patients
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Published on: April 12, 2011

Autonomic dysfunction in ICU-acquired weakness: a prospective observational pilot study.

L Wieske1, D R P P Chan Pin Yin, C Verhamme

  • 1Department of Intensive Care Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Room G3-228, P.O. Box 22700, 1105 AZ, Amsterdam, The Netherlands. L.Wieske@amc.uva.nl

Intensive Care Medicine
|June 25, 2013
PubMed
Summary

Intensive care unit-acquired weakness (ICU-AW) is common, but this study found no link between ICU-AW and autonomic dysfunction, measured by heart rate variability (HRV). Abnormal HRV was frequent in all critical illness patients, regardless of ICU-AW.

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Area of Science:

  • Critical Care Medicine
  • Neurology
  • Physiology

Background:

  • Intensive care unit-acquired weakness (ICU-AW) is a common neurological complication in critically ill patients.
  • Autonomic dysfunction is another frequent complication, but its relationship with ICU-AW is not well understood.

Purpose of the Study:

  • To investigate if patients with ICU-AW also develop autonomic dysfunction.
  • To determine if ICU-AW increases the likelihood of developing autonomic dysfunction.

Main Methods:

  • An observational cohort study involving 83 newly admitted ICU patients.
  • Daily heart rate variability (HRV) measurements for up to 15 days to assess autonomic function.
  • ICU-AW diagnosed using the Medical Research Council score; abnormal HRV defined by age-matched values.

Main Results:

  • 18% of patients developed ICU-AW.
  • Abnormal HRV was present in all critically ill patients (100%), irrespective of ICU-AW.
  • No association was found between ICU-AW and HRV; mechanical ventilation, sedation, and other factors were identified as confounders.

Conclusions:

  • Abnormal HRV is highly prevalent in critically ill patients, with or without ICU-AW.
  • ICU-AW is unlikely to be associated with a higher propensity for abnormal HRV.
  • Confounding factors may limit the accuracy of HRV as an indicator of autonomic dysfunction in critical illness.