Interventions for preventing critical illness polyneuropathy and critical illness myopathy
Citation: Hermans G, De Jonghe B, Bruyninckx F, et al. Interventions for preventing critical illness polyneuropathy and critical illness myopathy. Cochrane Database of Systematic Reviews 2014; (1): CD006832
What is this? Some patients with COVID-19 will become critically ill and need treatment in an intensive care unit (ICU). Critical illness myopathy and polyneuropathy weakness are common in ICU patients. Interventions that can prevent or reduce these complications during the severe, early phase of critical illness can speed up recovery.
In this Cochrane systematic review, the authors searched for randomized trials of the effects of treatments to prevent critical illness polyneuropathy and critical illness myopathy in adults in ICU. They did their main searches in September 2011 and repeated these in December 2013. Based on the 2011 search, the authors included five randomized trials. They identified 9 other studies in 2013 and these are awaiting assessment.
What works: Intensive insulin therapy to maintain normal sugar levels in critically ill adults prevented critical illness polyneuropathy, reduced time spent on mechanical ventilation and improved 180-day survival compared to conventional insulin therapy.
In one trial with missing data, early physical therapy may prevent critical illness polyneuropathy and critical illness myopathy and shorten duration of mechanical ventilation in critically ill adults.
What doesn’t work: Corticosteroids had no effect on preventing critical illness polyneuropathy and critical illness myopathy in critically ill adults or on their 60-day and 180-day mortality.
Electrical muscle stimulation treatment had no effect in preventing critical illness polyneuropathy and critical illness myopathy, the duration of mechanical ventilation or mortality for critically ill adults.
What’s uncertain: Nothing noted.
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