Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients

Krysta S. Wolfe, Bhakti K. Patel, Erica L. MacKenzie, Shewit P. Giovanni, Anne S. Pohlman, Matthew M. Churpek, Jesse B. Hall, John P. Kress

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background: Vasoactive 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. Methods: This 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. Results: On 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. Conclusions: In 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 Registry: ClinicalTrials.gov; No.: NCT01777035; URL: www.clinicaltrials.gov

Original languageEnglish (US)
Pages (from-to)781-787
Number of pages7
JournalCHEST
Volume154
Issue number4
DOIs
StatePublished - Oct 2018
Externally publishedYes

Keywords

  • ICUs
  • critical care outcomes
  • critical illness
  • humans
  • muscle weakness
  • vasoconstrictor agents

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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