Prolonged Neurogenic Weakness in Patients Requiring Mechanical Ventilation for Acute Airflow Limitation
| Autor: | K. Nagendran, Ian E.C. Ormerod, C. Ferguson, J. H. Coakley, Charles J. Hinds |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Artificial ventilation Weakness Time Factors medicine.medical_treatment Critical Care and Intensive Care Medicine Lesion Humans Medicine Myopathy Aged Mechanical ventilation business.industry Respiratory disease Neuromuscular Diseases Middle Aged Airway obstruction medicine.disease Respiration Artificial Asthma Anesthesia Acute Disease Female medicine.symptom Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Chest. 101:1413-1416 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.101.5.1413 |
| Popis: | We describe three patients who required mechanical ventilation for severe acute exacerbations of obstructive airways disease. When treatment with sedatives and muscle relaxants was withdrawn, they exhibited profound generalized weakness and consequently required prolonged ventilation despite resolution of the airway obstruction. Clinical features were variable, but none of the patients developed failure of other organs and infection was confined to the lungs. All had electrophysiologic evidence of a predominantly motor axonal syndrome. One patient in whom sensory action potentials were abnormal may represent an unusually severe case of critical illness neuropathy occurring in the absence of systemic sepsis and multiple organ failure. In the other two cases, this diagnosis is made less likely by the complete absence of sensory involvement and in these patients the lesion appeared to be either in the most distal portion of the motor neuron or at the neuromuscular junction. In all three patients, resolution was slow but eventually complete. The etiology of the condition is not clear, but it seems to be distinct from the acute myopathy previously described in asthmatics who had received mechanical ventilation. It is important to recognize this phenomenon to avoid erroneous conclusions about the likelihood of the patient recovering from ventilator dependence. A prolonged weaning period is to be expected in such cases. |
| Databáze: | OpenAIRE |
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