Critical illness polyneuropathy

Hund, E. (2001a). Critical illness polyneuropathy. Curr. Opin. Neurol. 14 649-53. 

Hund, E. (2001b). Neurological complications of sepsis critical illness polyneuropathy and myopathy. J. Neurol. 248 929-34. 

Waldhausen E, Mingers B, Lippers P, Keser G. Critical illness polyneuropathy due to parenteral nutrition. Intensive Care Med 1997 23(8) 922-3. 

Berek K, Margreiter J, Willeit J, Berek A, Schmutzhard E, Mutz N. Critical illness polyneuropathy—only due to parenteral nutrition Intensive Care Med 1997 23(8) 923-4. 

Biccard BM, Grant IS, Wright DJ, Nimmo SR, Hughes M. Suxamethonium and critical illness polyneuropathy. Anaesth Intensive Care 1998 26(5) 590-1. 

Imbalance between work of breathing and respiratory muscle capacity Critical illness polyneuropathy or myopathy Upper airway obstraction (e.g., tracheal stenosis)... 

In a study of 183 COPD patients with acute respiratory failure, 10.4% remained mechanically ventilated 21 days after intubation (11). In the same ICU, the relative risk of remaining ventilated at day 21 was twice as high in patients intubated for acute lung injury (21 of 107) (42). One explanation for the latter observation is the presence of either critical illness polyneuropathy or ICU-acquired paresis (ICUAP). In a study of 95 patients ventilated for at least seven days, one quarter developed ICUAP, resulting in a longer duration of MV (18 vs. 8 days in patients without ICUAP) (43). 

While cared for in the ICU, critically ill patients can develop muscle weakness and, occasionally, paralysis. Some of these patients have evidence of axonal degeneration (Table 2) and denervation atrophy (Fig. 10) (40). This constellation of findings is known as critical illness polyneuropathy. Sepsis and multiple organ failure, although common in these patients, are not essential prerequisites for the development of critical illness polyneuropathy (40). In other patients, rather than axonopathy, there is evidence of isolated myopathy (critical illness myopathy) (Fig. 11) (40). Patients developing isolated myopathy have often been treated with steroids and neuromuscular blocking agents (40). 

Although features of myopathy can be recorded by electromyographic studies, electromyography cannot always distinguish critical illness myopathy from critical illness polyneuropathy, and muscle biopsies may be... 

Gamacho-Montero J, Amaya-Villar R, Garcia-Garmendia JL, et al. Effect of critical illness polyneuropathy on the withdrawal from mechanical ventilation and the length of stay in septic... 

Zochodne DW, Bolton CF, Wells GA, et al. Critical illness polyneuropathy a complication of sepsis and multiple organ failure. Brain 1987 110 819. 

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