Early Mobilization

Question 1

What is major critical care treatment that goes beyond the confines of ICU

Answer 1

Mechanical Ventilation

Question 2

Patients with “chronic critical illness” (CCI) are what?

Answer 2

Ventilator-dependent survivors of castastrophic illness

Question 3

Characteristic derangement of? (4)

Answer 3

• Metabolism
• neuroendocrine
• Neuropsychiatric
• Immunologic function

Question 4

Multiple risk factors for post-ICU mortality include? (5)

Answer 4

• Age
• Comorbidity
• Severity of illness
• Duration of ICU delirium
• Sepsis

Question 5

Cumulative mortality over the first year after ICU ranges from

Answer 5

26-63%

Question 6

Post-intensive care syndrome (PICS) is term used to describe

Answer 6

• The constellation of complications that endure well past the ICU stay
• new or worsening impairments on physical, cognitive, or mental health status arising after critical illness and persisting beyond acute care hospitalization

Question 7

Long term complications include

Answer 7

• Pulmonary
• Neuromuscular
• Physical Function
• Psychiatric symptoms
• Cognitive
• QOL

Question 8

ICU-AW

Answer 8

Clinically detected weakness in critically ill patients in whom there is NO plausible etiology other than critical illness

Question 9

What does ICU-AW describes

Answer 9

The diffuse, symmetric, generalized muscle weakness (detected by physical examination and meeting specific strength- related criteria) that develops after the onset of critical illness without other identifiable cause

Question 10

ICU-AW is further classified as to 3

Answer 10

• critical illness myopathy (CIM)
• Critical illness polyneuropathy (CIP)
• Critical illness neuromyopathy (CINM)
  - –> CIP and CIM

Question 11

CIM –> cachectic myopathy is what?

Answer 11

Thick filament myopathy and necrotizing myopathy

Question 12

How to distinguishing between CIP and CIM

Answer 12

Electrophysiological testing and histology evaluation in involved tissues
-not a clear cut, similar clinical presentations

Question 13

Myopathy occurs when ?
Polyneuropathy occurs when ?

Which one required. Longer ICY stay ?

Answer 13

• Myopathy: eariler and more frequent
• Poyneuropathy: develops later and less frequent
• –> Poly = longer ICU stays

Question 14

5 clinical features of ICU-AW

-Diagnosis is the presence of which ones?

Answer 14

1. Weakness developing after the onset of critical illness
2. Weakness involves both proximal and distal muscles, symmetrical,
   flaccid and sparing the cranial nerves. It involves the limb, and respiratory muscles.
3. Muscle strength assessed by the MRC motor score is <48/60
4. Dependence on mechanical ventilation
5. Causes of weakness not related to the underlying critical illness

-1,2, 5, and either 3 or 4

Question 15

Etiology of ICU-AW is ?

Answer 15

Multifactorial

Question 16

What are the pathophysiologically important mechanism for ICU-AW

Answer 16

weakness include immobility, as well as local and
systemic inflammation, which act synergistically to
promote significant muscle loss in the critically ill patient.