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Erschienen in: Die Anaesthesiologie 8/2023

13.06.2023 | ICU-Acquired Weakness | Leitthema

Intensive Care Unit-Acquired Weakness – diagnostischer Stellenwert des neuromuskulären Ultraschalls

verfasst von: Dr. med. Felix Klawitter, DESAIC, Prof. Dr. med. habil. Uwe Walter, Prof. Dr. med. habil. Hubertus Axer, PD Dr. med. habil. Johannes Ehler

Erschienen in: Die Anaesthesiologie | Ausgabe 8/2023

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Zusammenfassung

Die Intensive Care Unit-Acquired Weakness (ICUAW) stellt eine der häufigsten neuromuskulären Komplikationen in der Intensivmedizin dar. Besonders bei analgosedierten, beatmeten oder deliranten Patienten können die klinische Diagnosestellung und Schweregradbeurteilung anhand etablierter diagnostischer Methoden (z. B. der klinischen Untersuchung mithilfe des Medical Research Council Sum Score oder elektrophysiologischen Untersuchungen) schwierig bis unmöglich werden. Der neuromuskuläre Ultraschall (NMUS) ist als eine einfach anwendbare, nichtinvasive und weitgehend von der Patienten-Compliance unabhängige Untersuchungsmöglichkeit zunehmend häufiger bei ICUAW untersucht worden. Hierbei konnte gezeigt werden, dass NMUS dazu geeignet zu sein scheint, eine ICUAW zu detektieren, den Schweregrad der muskulären Schwäche einzuschätzen und den klinischen Verlauf zu monitoren. Weiterführende Studien zur Vereinheitlichung der Untersuchungsmethodik, zur Evaluation des Trainingsaufwandes und zur Outcome-Prädikation sind notwendig. Die Formulierung eines interdisziplinären (neurologisch-anästhesiologischen) Weiterbildungscurriculums könnte die Grundlage der Etablierung des NMUS als komplementäres Verfahren zur Diagnostik der ICUAW in der klinischen Praxis bilden.
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Metadaten
Titel
Intensive Care Unit-Acquired Weakness – diagnostischer Stellenwert des neuromuskulären Ultraschalls
verfasst von
Dr. med. Felix Klawitter, DESAIC
Prof. Dr. med. habil. Uwe Walter
Prof. Dr. med. habil. Hubertus Axer
PD Dr. med. habil. Johannes Ehler
Publikationsdatum
13.06.2023
Verlag
Springer Medizin
Erschienen in
Die Anaesthesiologie / Ausgabe 8/2023
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-023-01300-5

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