Critical Illness Neuromuscular Abnormalities in Neurocritical Care Patients

Prospective Case-Only Study of Neuromuscular Pathology in Patients on Mechanical Ventilation in the Neurosurgical Intensive Care Unit

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT00893633

Enrollment

135

Registered

2009-05-06

Start date

2004-03-31

Completion date

2007-01-31

Last updated

2009-07-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Critical Illness, Muscle Weakness

Keywords

neuromuscular diseases, critical illness, mechanical ventilation, phrenic nerve, nerve conduction studies

Brief summary

The aim of this research is to investigate critical illness neuromuscular abnormalities in neurocritical care patients.

Detailed description

Since 1984, the problem of critical illness neuromuscular abnormalities (CINMAs) has attracted considerable interest. According to these studies, CINMAs include the muscular weakness that accompanies critical illness resulting from polyneuropathy and/or myopathy and can be seen in 25-85% of cases of critically ill patients. Clinically, CINMAs present as symmetric flaccid tetraparesis and difficulty weaning off mechanical lung ventilation. However, these data are derived from treating non-specialized intensive care unit (ICU) patients. In this research, we wished to investigate CINMAs in neurocritical care patients. From day one of the patients' participation in the research and until a discharge from the ICU (or death), daily neurological surveys and weekly nerve conduction studies were performed. Based on the results of each nerve conduction study, an index of neuromuscular damage was noted to evaluate the severity of the CINMAs. Needle electromyography and muscle biopsy were not used

Interventions

None listed

Study design

Observational model

CASE_ONLY

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

16 Years to No maximum

Healthy volunteers

Inclusion criteria

* Age: 16 years and older * Acute primary cerebral pathology * Mechanical ventilation * Signs of systemic inflammatory response * Exclusion of the possibility of an initial pathology of the spinal cord, peripheral nervous system and muscles in past medical history

Exclusion criteria

* Brain stem or bilateral hemispheric lesions with tetraparesis at the onset of illness * Inability to perform high-grade nerve conduction studies

Design outcomes

Primary

Measure	Time frame
incidence of critical illness neuromuscular abnormalities (CINMAs)	within the first week of mechanical ventilation

Secondary

Measure	Time frame
clinical and neurophysiological characteristics of CINMAs	within the first week of mechanical ventilation
influence оf phrenic nerve pathology on weaning from mechanical ventilation	during weaning period
dynamics of the neurophysiological characteristics of CINMAs	during stay in ICU

Countries

Russia

Outcome results