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Critical Illness Myopathy

George Barnes, MS, CCC-SLP

May 2, 2022

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Question

What is critical illness myopathy and what does it have to do with tracheostomy and ventilation?

Answer

Critical illness myopathy may occur in a medically complex patient who remains absent from functional activity for an extended period. This patient no longer has the resistance throughout the day needed to build their muscles. 62% of people who become ventilator-dependent begin to have some level of neuromuscular weakness (Shepherd et al., 2016). The reason the SLP needs to be aware of the high incidence of critical illness myopathy in the tracheostomy and ventilator dependent population is that the weakness is often widespread, substantial, and not limited to areas of the body that are below the neck. Lingual, labial, laryngeal, and pharyngeal function is often impacted by critical illness myopathy, causing significant issues with speaking and swallowing. This may lead to increased dependence and higher risks involved with introducing food and liquid; not only because of the high risk of aspiration but also because that aspiration may be more likely to result in a subsequent infection (Langmore et al., 1998 and 2002). 

To learn more about the care of patients with tracheostomy and/or mechanical ventilation and the role of the SLP, refer to SpeechPathology.com course, 20Q: Beyond the Swallow: Tracheostomy Tube and Ventilator Management


george barnes

George Barnes, MS, CCC-SLP

George Barnes MS CCC-SLP has developed an expertise in dysphagia with a focus on diagnostics in the medically complex population through his dedication to a variety of medical settings. George yearns to make education useful, research clinical-focused, and quality care accessible. His coaching program with FEESible Swallow Solutions supports SLPs with the guidance they need to reach their clinical and career goals. He co-founded a mobile FEES service to bring the highest quality assessment to the patient's bedside. His webinars bridge research and patient care. George strives to go beyond the swallow in dysphagia management by looking at the whole patient which is evident in his work on a pneumonia risk calculator. With a passion for food and a deep appreciation for the joy and connection it gives to our lives, he has dedicated his life to helping others enjoy this simple, but deep-rooted pleasure.


Related Courses

20Q: Beyond the Swallow - Tracheostomy Tube and Ventilator Management
Presented by George Barnes, MS, CCC-SLP
Text

Presenter

George Barnes, MS, CCC-SLP
Course: #10056Level: Intermediate1 Hour
  'Loved it! Precise and concise information'   Read Reviews
This course addresses the various questions that may arise for the medical SLP involved in the care of patients with tracheostomy and/or mechanical ventilation. Topics include causes of respiratory failure, consequences of tracheostomy/ventilation, risk management related to intervention, and considerations for assessment and treatment of swallowing and communication, including the use of speaking valves.

Breathe, Speak, Eat: What the SLP Needs to Know About Respiratory Failure
Presented by George Barnes, MS, CCC-SLP
Video

Presenter

George Barnes, MS, CCC-SLP
Course: #10445Level: Introductory1 Hour
  'A very comprehensive presentation covering practical information necessary for SLPs working in acute care/ critical care settings'   Read Reviews
This is Part 1 of a two-part series. Respiratory disease, respiratory failure, oral intubation, effects of intubation on the larynx and the swallow, and dysphagia management are discussed in this course. Risk factors and salient features of dysphagia after extubation are described in order to help clinicians effectively evaluate and treat their patients.

Breathe, Speak, Eat: What the SLP Needs to Know About Trachs and Vents
Presented by George Barnes, MS, CCC-SLP
Video

Presenter

George Barnes, MS, CCC-SLP
Course: #10461Level: Introductory1 Hour
This is Part 2 of a two-part series. An overview of tracheostomy tube and mechanical ventilator management, including their effects on airflow, speech and swallowing, is provided in this course. Discussion includes speaking valves, common challenges, and ways to improve outcomes in this complex patient population.

Aspiration Pneumonia Management in Complex Cases: Beyond the Swallow
Presented by George Barnes, MS, CCC-SLP
Video

Presenter

George Barnes, MS, CCC-SLP
Course: #10271Level: Intermediate1 Hour
  'Clearly and succinctly presented'   Read Reviews
This is Part 1 of a two-part series. How aspiration pneumonia develops, and a risk management approach that focuses not just on swallowing but on evaluating and treating the whole patient, are discussed. A multi-step system that can improve risk assessment and decision-making for patients with complex medical conditions and multiple risk factors for aspiration pneumonia is presented.

Aspiration Pneumonia Management in Complex Cases: Putting Theories into Practice
Presented by George Barnes, MS, CCC-SLP
Video

Presenter

George Barnes, MS, CCC-SLP
Course: #10276Level: Intermediate1 Hour
  'Efficient presentation for dysphagia decision making promoting IDT approach'   Read Reviews
This is Part 2 of a two-part series. Theories of aspiration pneumonia risk management are described in this course, including use of decision-making frameworks and management guidelines in interdisciplinary teams. Medically complex case studies are discussed to show how these theories can be put into practice to improve patient outcomes.

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