Abstract:
BACKGROUND:Vasoactive medications are commonly used in the treatment of critically ill patients, but their impact on the development of ICU-acquired weakness is not well described. The objective of this study is to evaluate the relationship between vasoactive medication use and the outcome of ICU-acquired weakness. METHODS:This is a secondary analysis of mechanically ventilated patients (N = 172) enrolled in a randomized clinical trial of early occupational and physical therapy vs conventional therapy, which evaluated the end point of ICU-acquired weakness on hospital discharge. Patients underwent bedside muscle strength testing by a therapist blinded to study allocation to evaluate for ICU-acquired weakness. The effects of vasoactive medication use on the incidence of ICU-acquired weakness in this population were assessed. RESULTS:On logistic regression analysis, the use of vasoactive medications increased the odds of developing ICU-acquired weakness (odds ratio [OR], 3.2; P = .01) independent of all other established risk factors for weakness. Duration of vasoactive medication use (in days) (OR, 1.35; P = .004) and cumulative norepinephrine dose (μg/kg/d) (OR, 1.01; P = .02) (but not vasopressin or phenylephrine) were also independently associated with the outcome of ICU-acquired weakness. CONCLUSIONS:In mechanically ventilated patients enrolled in a randomized clinical trial of early mobilization, the use of vasoactive medications was independently associated with the development of ICU-acquired weakness. Prospective trials to further evaluate this relationship are merited. TRIAL REGISTRY:ClinicalTrials.gov; No.: NCT01777035; URL: www.clinicaltrials.gov.
journal_name
Chestjournal_title
Chestauthors
Wolfe KS,Patel BK,MacKenzie EL,Giovanni SP,Pohlman AS,Churpek MM,Hall JB,Kress JPdoi
10.1016/j.chest.2018.07.016subject
Has Abstractpub_date
2018-10-01 00:00:00pages
781-787issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(18)31110-3journal_volume
154pub_type
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