["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.
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