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Bilateral Diaphragmatic Paralysis in a Patient With Critical Illness Polyneuropathy: A Case Report

Bilateral diaphragmatic paralysis (BDP) manifests as respiratory muscle weakness, and its association with critical illness polyneuropathy (CIP) was rarely reported. Here, we present a patient with BDP related to CIP, who successfully avoided tracheostomy after diagnosis and management. A 71-year-ol...

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Autores principales: Chen, Hsuan-Yu, Chen, Hung-Chen, Lin, Meng-Chih, Liaw, Mei-Yun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616567/
https://www.ncbi.nlm.nih.gov/pubmed/26252301
http://dx.doi.org/10.1097/MD.0000000000001288
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author Chen, Hsuan-Yu
Chen, Hung-Chen
Lin, Meng-Chih
Liaw, Mei-Yun
author_facet Chen, Hsuan-Yu
Chen, Hung-Chen
Lin, Meng-Chih
Liaw, Mei-Yun
author_sort Chen, Hsuan-Yu
collection PubMed
description Bilateral diaphragmatic paralysis (BDP) manifests as respiratory muscle weakness, and its association with critical illness polyneuropathy (CIP) was rarely reported. Here, we present a patient with BDP related to CIP, who successfully avoided tracheostomy after diagnosis and management. A 71-year-old male presented with acute respiratory failure after sepsis adequately treated. Repeated intubation occurred because of carbon dioxide retention after each extubation. After eliminating possible factors, septic shock-induced respiratory muscle weakness was suspected. Physical examination, a nerve conduction study, and chest ultrasound confirmed our impression. Pulmonary rehabilitation and reconditioning exercises were arranged, and the patient was discharged with a diagnosis of BDP. The diagnosis of BDP is usually delayed, and there are only sporadic reports on its association with polyneuropathy, especially in patients with preserved limb muscle function. Therefore, when physicians encounter patients that are difficult to wean from mechanical ventilation, CIP associated with BDP should be considered in the differential diagnosis.
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spelling pubmed-46165672015-10-27 Bilateral Diaphragmatic Paralysis in a Patient With Critical Illness Polyneuropathy: A Case Report Chen, Hsuan-Yu Chen, Hung-Chen Lin, Meng-Chih Liaw, Mei-Yun Medicine (Baltimore) 6300 Bilateral diaphragmatic paralysis (BDP) manifests as respiratory muscle weakness, and its association with critical illness polyneuropathy (CIP) was rarely reported. Here, we present a patient with BDP related to CIP, who successfully avoided tracheostomy after diagnosis and management. A 71-year-old male presented with acute respiratory failure after sepsis adequately treated. Repeated intubation occurred because of carbon dioxide retention after each extubation. After eliminating possible factors, septic shock-induced respiratory muscle weakness was suspected. Physical examination, a nerve conduction study, and chest ultrasound confirmed our impression. Pulmonary rehabilitation and reconditioning exercises were arranged, and the patient was discharged with a diagnosis of BDP. The diagnosis of BDP is usually delayed, and there are only sporadic reports on its association with polyneuropathy, especially in patients with preserved limb muscle function. Therefore, when physicians encounter patients that are difficult to wean from mechanical ventilation, CIP associated with BDP should be considered in the differential diagnosis. Wolters Kluwer Health 2015-08-07 /pmc/articles/PMC4616567/ /pubmed/26252301 http://dx.doi.org/10.1097/MD.0000000000001288 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 6300
Chen, Hsuan-Yu
Chen, Hung-Chen
Lin, Meng-Chih
Liaw, Mei-Yun
Bilateral Diaphragmatic Paralysis in a Patient With Critical Illness Polyneuropathy: A Case Report
title Bilateral Diaphragmatic Paralysis in a Patient With Critical Illness Polyneuropathy: A Case Report
title_full Bilateral Diaphragmatic Paralysis in a Patient With Critical Illness Polyneuropathy: A Case Report
title_fullStr Bilateral Diaphragmatic Paralysis in a Patient With Critical Illness Polyneuropathy: A Case Report
title_full_unstemmed Bilateral Diaphragmatic Paralysis in a Patient With Critical Illness Polyneuropathy: A Case Report
title_short Bilateral Diaphragmatic Paralysis in a Patient With Critical Illness Polyneuropathy: A Case Report
title_sort bilateral diaphragmatic paralysis in a patient with critical illness polyneuropathy: a case report
topic 6300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616567/
https://www.ncbi.nlm.nih.gov/pubmed/26252301
http://dx.doi.org/10.1097/MD.0000000000001288
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