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.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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