["Critical-illness" polyneuropathy and -myopathy].
Critical-illness polyneuropathy and myopathy (CIPNM) can be considered a part of the syndrome of multiple organ dysfunction. CIPNM is the commonest cause of muscle weakness acquired in the intensive care unit. Its incidence is 35-80% during prolonged mechanical ventilation. For a (differential) diagnosis, electrophysiological investigations are usually necessary, and sometimes a muscle biopsy. CIPNM may be induced by triggering of the immune response leading to increased vascular permeability with tissue invasion of inflammatory cells and local damage. There is a relation between myopathy and medication, notably corticosteroids. Clinical improvement usually follows when the CIPNM patient survives the underlying disease, but weaning from artificial ventilation is often difficult, and rehabilitation prolonged.
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Afd. Klinische Neurofysiologie, Universitair Medisch Centrum Utrecht.
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D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D006801:Humans; D009102:Multiple Organ Failure / Q000150:complications* / Q000503:physiopathology; D009135:Muscular Diseases / Q000209:etiology*; D011115:Polyneuropathies / Q000209:etiology*; D012121:Respiration, Artificial / Q000009:adverse effects*; D016896:Treatment Outcome; D015300:Ventilator Weaning