ICU Acquired Weakness Clinical Trial
Official title:
Association Between Thyroid Dysfunction and Intensive Care Unit Acquired Weakness: A Case Control Study
Intensive care unit-acquired weakness (ICU-AW) is the most common neuromuscular impairment in critically ill patients. It affects more than 50 % of patients in the intensive care and is related to many problems as difficult weaning from mechanical ventilation, prolonged hospital stay and increased mortality.Thyroid disorders are also associated with neuromuscular abnormalities and may decrease the threshold for the development of any type of myopathy. However, no previous study investigated the direct relationship between thyroid dysfunction and ICUAW.This study aims at evaluation of the association between thyroid dysfunction and intensive care unit acquired weakness.
Intensive care unit acquired weakness refers to muscle weakness encountered in the intensive
care unit as a consequence of critical illness. It affects more than 50 % of patients in the
intensive care and is related to many problems as difficult weaning from mechanical
ventilation, prolonged hospital stay and increased mortality.
There are three distinct entities for ICUAW that can only be differentiated by
neurophysiological studies. These are critical illness myopathy (CIM), critical illness
polyneuropathy (CIP) and critical illness neuromyopathy (CINM).
Identification of risk factors responsible for the development of ICUAW is the first step in
the prevention and management of this disorder. Till time septic shock, hyperglycemia, high
dose steroid therapy, prolonged mechanical ventilation and the use of neuromuscular blocking
agents are the main accused.
Thyroid disorders are also associated with neuromuscular abnormalities. Unfortunately, the
prevalence of thyroid dysfunction in the intensive care is high reaching 90%. Moreover,
patients with severe critical illness, who are typically prone to the development of ICUAW,
show changes in their thyroid biochemistry namely low T3 levels (with or without low T4
levels) in the presence of normal TSH levels. These changes are collectively known as
Non-Thyroidal illness syndrome (previously low T3 syndrome and Euthyroid sick syndrome) which
is the most common form of thyroid dysfunction in the intensive care unit.
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