• Krysta S Wolfe, Bhakti K Patel, Erica L MacKenzie, Shewit P Giovanni, Anne S Pohlman, Matthew M Churpek, Jesse B Hall, and John P Kress.
• Section of Pulmonary and Critical Care, Department of Medicine, University of Chicago, Chicago, IL. Electronic address: krysta.wolfe@uchospitals.edu.
• Chest. 2018 Oct 1; 154 (4): 781-787.

BackgroundVasoactive medications are commonly used in the treatment of critically ill patients, but their impact on the development of ICU-acquired weakness is not well described. The objective of this study is to evaluate the relationship between vasoactive medication use and the outcome of ICU-acquired weakness.MethodsThis is a secondary analysis of mechanically ventilated patients (N = 172) enrolled in a randomized clinical trial of early occupational and physical therapy vs conventional therapy, which evaluated the end point of ICU-acquired weakness on hospital discharge. Patients underwent bedside muscle strength testing by a therapist blinded to study allocation to evaluate for ICU-acquired weakness. The effects of vasoactive medication use on the incidence of ICU-acquired weakness in this population were assessed.ResultsOn logistic regression analysis, the use of vasoactive medications increased the odds of developing ICU-acquired weakness (odds ratio [OR], 3.2; P = .01) independent of all other established risk factors for weakness. Duration of vasoactive medication use (in days) (OR, 1.35; P = .004) and cumulative norepinephrine dose (μg/kg/d) (OR, 1.01; P = .02) (but not vasopressin or phenylephrine) were also independently associated with the outcome of ICU-acquired weakness.ConclusionsIn mechanically ventilated patients enrolled in a randomized clinical trial of early mobilization, the use of vasoactive medications was independently associated with the development of ICU-acquired weakness. Prospective trials to further evaluate this relationship are merited.Trial RegistryClinicalTrials.gov; No.: NCT01777035; URL: www.clinicaltrials.gov.Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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