Does ICU-acquired paresis lengthen weaning from mechanical ventilation?
OBJECTIVE: To determine whether ICU-acquired paresis (ICUAP) is an independent risk factor of prolonged weaning. DESIGN: Second study of a prospective cohort of 95 patients who were enrolled in an incidence and risk factor study of ICUAP. SETTING: Three medical and two surgical ICUs in four hospitals. PATIENTS AND PARTICIPANTS: Ninety-five patients without pre-existing neuromuscular disease recovering from the acute phase of critical illness after > or =7 days of mechanical ventilation. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Duration of weaning from mechanical ventilation was defined as the duration of mechanical ventilation between awakening (day 1) and successful weaning. Muscle strength was evaluated at day 7 after awakening using the Medical Research Council (MRC) score. Patients with an MRC <48 were considered to have ICUAP. Among the 95 patients (mean age 62.0+/-15.3 years, SAPS 2 on admission 48.7+/-17.4) who regained satisfactory awakening after 7 or more days of mechan