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01.02.2014 | Übersichten

Erworbene Muskelschwäche des kritisch Kranken

Pathogenese, Behandlung, Rehabilitation, Outcome

verfasst von: Dr. M. Ponfick, K. Bösl, J. Lüdemann-Podubecka, G. Neumann, M. Pohl, D.A. Nowak, H.-J. Gdynia

Erschienen in: Der Nervenarzt | Ausgabe 2/2014

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Zusammenfassung

Die Diagnose „erworbene Muskelschwäche des kritisch Kranken“ (ICUAW) nimmt in der neurologischen Rehabilitation stetig zu. Ursächlich hierfür ist die verbesserte intensivmedizinische Behandlung von Patienten mit Sepsis oder komplikationsreichen kardio- und viszeralchirurgischen Eingriffen. Die ICUAW erschwert die Rehabilitation durch das verlängerte Weaning vom Respirator sowie die häufigen internistischen Begleiterkrankungen. Die Patienten zeigen klinisch eine schlaffe (Tetra-)Parese sowie elektrophysiologisch Zeichen einer axonalen neuronalen Schädigung. Darüber hinaus kann eine Schädigung der Muskulatur (Critical-illness-Myopathie) zu einer erworbenen Schwäche des kritisch Kranken führen. Elektrophysiologisch lassen sich hierbei teils myopathische Veränderungen finden. Auch Mischformen kommen vor. Aufgrund der bislang nicht eindeutig geklärten Pathogenese sowie deren Komplexität existiert eine spezifische Therapie der ICUAW nicht, die Patienten profitieren jedoch von einer frühzeitigen Mobilisation auf der Intensivstation. Diese Übersichtsarbeit gibt anhand der aktuellen Literatur Einblicke in die Ätiologie sowie die Diagnostik der ICUAW. Darüber hinaus werden Studien zur Rehabilitation und zum Outcome eingehend betrachtet und diskutiert.

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Titel: Erworbene Muskelschwäche des kritisch Kranken
Pathogenese, Behandlung, Rehabilitation, Outcome
verfasst von: Dr. M. Ponfick
K. Bösl
J. Lüdemann-Podubecka
G. Neumann
M. Pohl
D.A. Nowak
H.-J. Gdynia
Publikationsdatum: 01.02.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Der Nervenarzt / Ausgabe 2/2014
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-013-3958-6

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