Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr De Jonghe and colleagues1 diagnosed ICUAP based on a bedside clinical examination
in patients who regained consciousness after long-term mechanical ventilation.
The authors questioned the reliability and the necessity of electrophysiological
testing to detect ICUAP.
In contrast, we recommend initial electrophysiological testing for diagnosis
of ICUAP in the early clinical course of intensive care unit (ICU) patients,
if bedside neurological examination cannot be performed due to use of sedatives
and analgesics.2,3 Many
patients receiving mechanical ventilation are also given sedatives and analgesics.
It is important to assess for muscular paresis, which could interfere with
early spontaneous breathing and lead to weaning failure. Thus, early electrophysiological
testing as a diagnostic tool for ICUAP has great clinical value.
Weber-Carstens S, Bercker S, Busch T, Kaisers U. Paresis Following Mechanical VentilationParesis Following Mechanical Ventilation. JAMA. 2003;289(13):1633-1635. doi:10.1001/jama.289.13.1633-a