Perceived utility of electrodiagnostic testing in critical illness myopathy and polyneuropathy: A survey of intensive care unit providers.


Journal

Muscle & nerve
ISSN: 1097-4598
Titre abrégé: Muscle Nerve
Pays: United States
ID NLM: 7803146

Informations de publication

Date de publication:
07 2022
Historique:
revised: 14 04 2022
received: 23 06 2021
accepted: 17 04 2022
pubmed: 27 4 2022
medline: 16 6 2022
entrez: 26 4 2022
Statut: ppublish

Résumé

Critical illness myopathy (CIM) and critical illness polyneuropathy (CIP) are common disorders associated with substantial morbidity. Electrodiagnostic studies (EDx) are effective in diagnosing CIM/CIP and identifying mimicking conditions. We surveyed intensive care unit (ICU) providers to better understand their approach to ICU-acquired weakness (ICU-AW) and the perceived utility of EDx. This was a single health system, Web-based survey of ICU providers. Survey responses were received from 52 providers with a response rate of 22.1%. Most providers were somewhat familiar with CIM/CIP and median perceived prevalence was 30-49%. The majority (92.3%) of providers had no standard evaluation approach for ICU-AW. Electrodiagnostic testing was commonly considered, but many providers obtained it infrequently in presumed CIM/CIP cases. Electrodiagnostic studies were used to rule out other causes of weakness or to confirm the diagnosis of CIM/CIP. Many providers ordered EDx within 1 wk of identifying weakness. Finally, EDx were overshadowed by personal experience as the most helpful management tool for ICU-AW. Overall, ICU providers perceive that CIM/CIP are commonly encountered, but they may not have a standard approach to evaluation. Clinical experience increased familiarity of ICU-AW and is central to management. EDx results are usually thought to be helpful, albeit not often ordered, and more study is needed to determine when implementation is of most assistance. Increasing education and developing institutional standards may lead to increased awareness and improved evaluation of CIM/CIP, but more study is needed to determine if algorithmic approaches would change patient outcomes.

Identifiants

pubmed: 35470438
doi: 10.1002/mus.27561
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

90-95

Informations de copyright

© 2022 Wiley Periodicals LLC.

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Auteurs

Michael Isfort (M)

Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.

Bryan J McVerry (BJ)

Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Lori Shutter (L)

Departments of Critical Care Medicine, Neurology and Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Minji Kim (M)

Providence Neurology, Medford, Oregon, USA.

David Lacomis (D)

Departments of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Pathology (Neuropathology), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

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