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Acute Weakness in Intensive Care

  • Louise Barnes
  • Michael Vucevic
Chapter
Part of the Competency-Based Critical Care book series (CBCC)

Key Points

  1. 1.

    Acute weakness may directly lead to a requirement for critical care or may occur during an episode of critical illness, that is, critical- care neuropathy.

     
  2. 2.

    Treatment requires a multidisciplinary approach. Pain control, nutrition, pressure area care, thrombo-prophylaxis, physiotherapy, and psychological care must all be addressed for the best outcome to be achieved.

     
  3. 3.

    Guillain–Barré syndrome is one of the commonest causes of acute weakness seen on the ITU.

     
  4. 4.

    Serial assessments of the respiratory system, including spirometry help to evaluate the progress of the disease, and the need for critical-care support.

     
  5. 5.

    Bulbar palsy and swallowing difficulties must be recognized early, otherwise aspiration and subsequent pneumonia may occur.

     
Acute weakness as a cause for admission to Intensive Care is common and is typified by:
  1. 1.

    Impaired respiratory muscle function requiring ventilatory support

     
  2. 2.

    Inability to cough or clear secretions

     
  3. 3.

    Secondary complications of the disease process, for example, sepsis, myocardial infarction (MI)

     

Keywords

Spinal Muscular Atrophy Autonomic Dysfunction Percutaneous Endoscopic Gastrostomy Tube Critical Illness Myopathy Myasthenic Crisis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Bhardwaj A, Mirski M, Ulatowski J (eds) (2004) Handbook of neurocritical care. Humana Press, New Jersey, USA, pp 199–212Google Scholar
  2. Chan-Tack KM, Bartlett J (2004) Botulism. E-MedicineGoogle Scholar
  3. Cheng BC, Chang WN et al (2004) Predictive factors and long-term outcome of respiratory failure after guillain barre syndrome. Am J Med Sci 327(6):336–340CrossRefPubMedGoogle Scholar
  4. Fanion D(2004) Guillain Barre Syndrome. E-medicineGoogle Scholar
  5. Hughes RA, Raphael JC, Swan AV, Doorn PA (2004) Intravenous Immunoglobulin for Guillain Barre Syndrome. Cochrane Database of Reviews (1):CD002063Google Scholar
  6. Kumar R (2002) Guillain barre syndrome. JIACM 3(4):389–391Google Scholar
  7. Richards K, Cohen A (2003) Guillain-Barre syndrome. BJA, CEPD Reviews 3(2):46–49Google Scholar
  8. Thwaites CL, Yen LM, Laon HT et al (2006) Magnesium sulphate for treatment of severe tetanus: a randomised controlled trial. Lancet 368(9545):1398–1399CrossRefGoogle Scholar
  9. Raphael J-C, Chevret S, Hughes RAC Plasma exchange for Guillain Barre syndrome. Cochrane Review CD-ROM. Oxford, EnglandGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2010

Authors and Affiliations

  • Louise Barnes
    • 1
  • Michael Vucevic
    • 2
  1. 1.Hull Royal Infirmary Hull and East Yorkshire Hospitals NHS TrustHullUK
  2. 2.Department of AnestheticsLeeds General Infirmary Leeds Teaching Hospitals NHS TrustLeedsUK

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