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Bernard De Jonghe R animation M dico-Chirurgicale, Poissy bdejonghechi-poissy-st-germain.fr

Une d?faillance d'organe particuli?re?. Neuromyopathies de R?animation. D?faillance h?modynamique. D?faillance respiratoire. D?faillance r?nale. D?faillance neurol. centrale. D?faillance h?patique. . . . . Admission r?a. R?veil. Sortie r?a. D?faillance h?matologique. D?faillance neuromusculaire. . A

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Bernard De Jonghe R animation M dico-Chirurgicale, Poissy bdejonghechi-poissy-st-germain.fr

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    1. Bernard De Jonghe Réanimation Médico-Chirurgicale, Poissy bdejonghe@chi-poissy-st-germain.fr

    2. Une défaillance d’organe particuličre…

    3. Les enjeux

    4. Anomalies neuromusculaires impliquées

    5. Identification de l’atteinte des membres au début du sevrage Déficit moteur 4 membres proximal épargne face Déficit sensitif Hyporéflexie Amyotrophie

    6. Assessment of Muscle Strength The MRC Score

    7. Incidence of ICU-Acquired Paresis

    8. Face ŕ un patient avec une faiblesse musculaire, un ENMG n’est pas indispensable quand…

    9. Frequency of ENMG Abnormalities Prospective Cohort Studies

    10. ENMG?

    13. Atteinte neuromusculaire respiratoire

    14. Neuromuscular disorders and weaning failure

    15. Combined assessment of limb and respiratory muscle strength in CINM (GRENER 2 study)

    16. Duration of MV after awakening

    17. Duration of weaning

    18. Duration of limb muscle weakness

    21. Risk Factors for CINM Prospective Cohort Studies with Multivariate Analysis

    22. Utilisation des corticosteroďdes en réanimation

    24. Role of Corticosteroids Prospective cohort studies including CS in a multivariate analysis

    25. Independent determinants of ICU-Acquired Paresis

    26. Independent determinants of « Critical Illness Polyneuropathy »

    28. Facteurs de risque des neuromyopathies de réanimation

    29. Effect of mechanical ventilation on diaphragmatic function Ventilator-induced diaphragmatic dysfunction

    31. Effect of rocuronium on diaphragmatic function

    32. Facteurs de risque des neuromyopathies de réanimation

    33. Intensive insulin therapy in surgical critically ill patients

    34. Intensive insulin therapy in medical critically ill patients

    35. Conclusions

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