AACN advanced critical care
-
Critical illness polyneuromyopathy, a complication of critical illness, is a primary axonal degeneration of motor and sensory fibers that leads to skeletal muscle weakness. It significantly contributes to the unexplained difficulty in weaning from mechanical ventilation and to their prolonged rehabilitation and poor quality of life after discharge. This article will discuss the diagnosis of critical illness polyneuromyopathy, identify risk factors, review several pathomechanisms that have been proposed, and discuss the implications for practice.
-
Ventilator-associated pneumonia (VAP) is a significant clinical problem associated with increased intensive care unit and hospital length of stay and substantial increases in delivery cost and associated morbidity and mortality. With system changes and management of the environment of care, the incidence of VAP was reduced in seven of our intensive care units across the system. ⋯ Patient positioning, oral care, nutrition, and management of comfort drugs are a few of the processes addressed to reduce VAP. Standardization of these essential care practices can reduce the incidence of this nosocomial infection and its associated increases in the cost of care delivery and mortality.