Prediction and Outcome of Weakness in the Intensive Care Unit.

Intensive care unit - acquired weakness (ICU-AW) is a frequent and important
complication of critical illness. Patients suffer from severe weakness
affecting extremities but also respiratory muscles. ICU-AW causes increased
mortality, longer duration of mechanical ventilation and protracted recovery
after a critical illness. The most important risk factors for development of
ICU-AW are sepsis and the systemic inflammatory response syndrome (SIRS).
Diagnosing ICU-AW is difficult. Due to concomitant disorders of consciousness
conventional diagnostic methods for diagnosing weakness, i.e the neurological
examination, is not possible at an early stage. This leads to a delayed
diagnosis of ICU-AW which hampers clinical decision making on for example
tracheostomy and rehabilitation strategies.

To develop a screening test to predict ICU-AW at an early stage in patients
admitted to the ICU. Also by prospectively following the patient group in time,
this study aims to describe the natural history and functional limitations in
patients suffering from ICU-AW.

Prospective cohort study.

Depending on when the patient awakens, he or she will be screened once or
multiple times. Every screening examination will take about 10 minutes. After
awakening, a clinical neurological examination will be preformed also taking
about 10 minutes. If the patients consents to partcipate in the follow up
study, he or she will be contacted via telephone three times. One interview at
3, 6 and 12 months after discharge. Every interview will take about 15 minutes
to complete.

Electrophysiological studies used in this project are used and accepted
worldwide. For this project extra stringent safety requirements have been
developed which will be evaluated before every examination. The risk for the
patient will be negligible.