Medical Diagnosis: Weber-Carstens et al. (2010, p. 1) reported that diagnosis of CIM is made either clinical evidence of muscle weakness after removal of sedation as characterized by weak and flaccid extremities, in addition, electromyography (EMG) and muscle biopsy can be performed to distinguish between the different types of ICU-acquired weakness. John and Bapat (2015, p. 157) believed that EMG and muscle biopsy is impractical to perform in the ICU; therefore, he asserted that clinical diagnosis using diagnostic criteria is more feasible. Examples of these rules are as follows: Generalized weakness developing after the onset of acute illness, weakness is diffuse (involving both proximal and distal muscles), symmetrical,
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Muscle weakness can be tested once the patient sedation has been reduced and voluntary muscle contraction is tested. Prognosis: CIM has been correlated with prolonged improvement in the ICU. Khoiny & Behrouz (2011, p. 56) describes that manifestation of muscle atrophy, foot drop and decreased reflexes are linked with CIM. Prognosis depends on the amount of muscle damage. For mild to moderate affectation, full recovery can be expected for weeks. However, in the severe form of the disease, recovery can take longer; up to months with only partial recovery may be achieved (Chawla & Gruener 2010, p. 972). Medical Management: Unfortunately CIM does not have a specific medical therapy. According to Chawla & Gruener (2010, p. 971), treatments are mainly supportive and symptomatic. First, neurologic assessments must regularly be performed to document any unexpected neurologic changes. Second, vascular management for prophylaxis for deep vein thrombosis; respiratory therapy is necessary to minimize risk for pulmonary infection. Third, integumentary protection measures should be started using pressure relieving mattress to avert the incident of pressure ulcers and ensuring frequent turning program is optimize and finally, involvement of physical medicine and rehabilitation physician to sort out and assist potential obstacle in starting an early mobilization
Muscle weakness can be tested once the patient sedation has been reduced and voluntary muscle contraction is tested. Prognosis: CIM has been correlated with prolonged improvement in the ICU. Khoiny & Behrouz (2011, p. 56) describes that manifestation of muscle atrophy, foot drop and decreased reflexes are linked with CIM. Prognosis depends on the amount of muscle damage. For mild to moderate affectation, full recovery can be expected for weeks. However, in the severe form of the disease, recovery can take longer; up to months with only partial recovery may be achieved (Chawla & Gruener 2010, p. 972). Medical Management: Unfortunately CIM does not have a specific medical therapy. According to Chawla & Gruener (2010, p. 971), treatments are mainly supportive and symptomatic. First, neurologic assessments must regularly be performed to document any unexpected neurologic changes. Second, vascular management for prophylaxis for deep vein thrombosis; respiratory therapy is necessary to minimize risk for pulmonary infection. Third, integumentary protection measures should be started using pressure relieving mattress to avert the incident of pressure ulcers and ensuring frequent turning program is optimize and finally, involvement of physical medicine and rehabilitation physician to sort out and assist potential obstacle in starting an early mobilization