ICU-Acquired Weakness Is Associated With Differences in Clinical Outcomes in @entity3124 XXXX .

@entity1 @entity3124 @entity16 @entity425 @entity281 @entity1576
OBJECTIVE: ICU-acquired @entity425 , comprised @entity3124 and @entity16 , occurs in a significant proportion of @entity3124 adults and is associated with high morbidity and mortality. Little is known about ICU-acquired @entity425 among @entity3124 @entity1 . We investigated the incidence of ICU-acquired @entity425 among PICUs participating in the Virtual PICU Systems database. We also sought to identify associated risk factors for ICU-acquired @entity425 and evaluate the hypothesis that ICU-acquired @entity425 is associated with poor clinical outcomes. DESIGN: Retrospective cohort study. SETTING: PICU. MEASUREMENTS AND MAIN RESULTS: Virtual PICU System was queried for @entity3124 and @entity16 between January 2009 and November 2013. Demographic, admission, and clinical outcome variables including mechanical ventilation days, PICU length of stay, and discharge disposition were analyzed. The Pediatric Index of Mortality-2 was used to evaluate and control for illness severity and risk of mortality. Among 203,875 admissions, there were 55 cases of @entity3124 reported and no cases of @entity16 , resulting in an incidence of 0.02%. Mechanical ventilation days were higher among @entity1 with ICU-acquired @entity425 versus those who did not develop ICU-acquired @entity425 (31.6    28.9 vs 9.3    20.6; p < 0.001). In our multivariable analysis, when controlling for Pediatric Index of Mortality-2, ICU-acquired @entity425 was more frequently reported in those with admission diagnoses of @entity1576 and @entity281 and the need for mechanical ventilation, renal replacement therapy, extracorporeal life support, and tracheostomy. ICU-acquired @entity425 was associated with a longer PICU length of stay, episodes requiring mechanical ventilation, and discharge to an intermediate, chronic care, and rehabilitation care unit. ICU-acquired @entity425 was not independently associated with mortality. CONCLUSIONS: ICU-acquired @entity425 is uncommonly diagnosed among PICU @entity1 reported in Virtual PICU System. ICU-acquired @entity425 is associated with critical care therapies, invasive procedures, and resource utilization. Limitations of our retrospective study include underrecognition of ICU-acquired @entity425 and lack of standardized diagnostic criteria within Virtual PICU System. Prospective studies are needed to better understand the true incidence, risk factors, and clinical course for @entity1 who develop ICU-acquired @entity425 .
