Critical illness polyneuromyopathy (CIPNM); rehabilitation during critical illness. Therapeutic options in nursing to promote recovery: a review of the literature.
Following critical illness requiring prolonged mechanical ventilation and sedation, intensive care patients often present with neuromuscular weakness. This results from critical illness polyneuropathy (CIP) and critical illness myopathy (CIM). A lack of diagnostic criteria for each syndrome complicates prevention and treatment. Consequently the term critical illness polyneuromyopathy (CIPNM) has emerged and is characterised by severe weakness, reduced or absent limb reflexes and marked muscle wasting. Although clinical trials report a high incidence of CIPNM, in clinical practice it often remains undetected. The pathophysiological mechanisms that lead to neuromuscular weakness are not entirely clear, however several risk factors have been identified and will be discussed. To date, there are no specific treatments or interventions available to reduce the onset or impact of CIPNM. This paper will review the strategies employed that are supportive and aimed at controlling the associated risk factors.
Critical Care Sister, Lancashire Teaching Trust, Preston, United Kingdom. eamonandnic@btinternet.com
Nicola
N
Doherty
Colin D
CD
Steen
D016638:Critical Illness; D004434:Early Ambulation; D006801:Humans; D009135:Muscular Diseases / Q000209:etiology / Q000451:nursing / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D011115:Polyneuropathies / Q000209:etiology / Q000451:nursing / Q000534:rehabilitation*; D016059:Range of Motion, Articular; D012307:Risk Factors