Critical illness neuromuscular syndromes.
Critical illness neuromyopathy (CINM) is the most common peripheral neuromuscular disorder encountered in the ICU. Bilateral diffuse weakness predominant in the proximal part of the limbs after improvement of the acute phase of the critical illness is highly suggestive of CINM. Although muscle and peripheral nerve often are involved in combination, muscle involvement alone increasingly is identified on electrophysiological investigation, including direct muscle stimulation. Respiratory muscles also are involved, and CINM may cause delayed weaning and prolonged MV. Besides muscle immobilization and prolonged sepsis-induced multiple organ failure, which are both strong contributors to CINM, hyperglycemia and use of corticosteroids also might have a deleterious effect on the neuromuscular system in critically ill patients.
De Jonghe
Bernard
B
Service de Réanimation Médico-chirurgicale, Centre Hospitalier de Poissy, 10 rue du Champ-Gaillard, 78300 Poissy, France. bdejonghe@chi-poissy-st-germain.fr
Lacherade
Jean-Claude
JC
Durand
Marie-Christine
MC
Sharshar
Tarek
T
D000818:Animals; D001510:Bed Rest / Q000009:adverse effects; D015897:Comorbidity; D016638:Critical Illness / Q000453:epidemiology*; D004599:Electric Stimulation Therapy; D004576:Electromyography; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007362:Intensive Care Units; D009468:Neuromuscular Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D012121:Respiration, Artificial; D012132:Respiratory Muscles / Q000503:physiopathology; D018805:Sepsis / Q000503:physiopathology; D013577:Syndrome
D005938:Glucocorticoids