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A framework for diagnosing and classifying intensive care unit-acquired weakness

Stevens, Robert D. MD; Marshall, Scott A. MD; Cornblath, David R. MD; Hoke, Ahmet MD, PhD; Needham, Dale M. MD, PhD; de Jonghe, Bernard MD; Ali, Naeem A. MD; Sharshar, Tarek MD, PhD

doi: 10.1097/CCM.0b013e3181b6ef67
Scientific Reviews

Neuromuscular dysfunction is prevalent in critically ill patients, is associated with worse short-term outcomes, and is a determinant of long-term disability in intensive care unit survivors. Diagnosis is made with the help of clinical, electrophysiological, and morphological observations; however, the lack of a consistent nomenclature remains a barrier to research. We propose a simple framework for diagnosing and classifying neuromuscular disorders acquired in critical illness.

From the Division of Neurosciences Critical Care (RDS, SAM), Departments of Anesthesiology Critical Care Medicine (RDS, SAM), Neurology (RDS, SAM, DRC, AH), Neurosurgery (RDS, SAM); Division of Pulmonary and Critical Care Medicine (DMN), Departments of Medicine (DMN) and of Physical Medicine and Rehabilitation (DMN), The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Neurology (SAM), Uniformed Services University of the Health Sciences, Bethesda, MD; Réanimation Médico-Chirurgicale (BdJ), Centre Hospitalier de Poissy-Saint-Germain, Poissy, France; Division of Pulmonary, Allergy, Critical Care and Sleep Medicine (NAA), Ohio State University, Columbus, OH; and Raymond Poincaré Hospital (AP-HP) (TS), Faculty of Medicine, University of Versailles Saint-Quentin en Yvelines Garches, France.

The opinions expressed in this manuscript belong solely to those of the authors, and they should not be interpreted as representative or endorsed by the Uniformed Services University, U.S. Army, Department of Defense, or any other agency of the federal government of the United States.

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© 2009 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins