title: Critical illness polyneuromyopathy.
abstract: OBJECTIVE
  The clinical characteristics of and treatment approaches for critical illness polyneuromyopathy (CIPNM) are reviewed.
  
  
  CONCLUSIONS
  CIPNM is an acute axonal sensory-motor polyneuropathy that tends to occur after the development of respiratory insufficiency in patients with systemic inflammatory response syndrome, sepsis, or multiple-organ dysfunction syndrome. Numerous mechanisms have been proposed to explain the pathophysiology of CIPNM, most of which are complex and not fully understood or proven. While the rate of intensive care unit-acquired weakness varies greatly among patients, an estimated 25-85% of critically ill adult patients will develop neuromuscular weakness, most commonly CIPNM, during hospitalization. While no specific pharmacologic treatments exist for CIPNM, the outcome for most patients is related to the severity of the illness and neuromyopathy, as well as early intervention to treat the underlying condition. Electrophysiologic studies, such as electromyography, electroneurography, and muscle and nerve biopsies, are considered the gold standard for aiding in the diagnosis of CIPNM. Preventive measures such as the early provision of appropriate nutrition, glucose control, physical rehabilitation, and the cautious use of medications such as corticosteroids and neuromuscular blocking agents (NMBAs) can help reduce the occurrence of CIPNM.
  
  
  CONCLUSIONS
  CIPNM is an acute axonal sensory-motor polyneuropathy commonly seen in critically ill patients with sepsis and multiorgan failure. While no specific pharmacologic treatments exist, preventive measures such as the early provision of appropriate nutrition, glucose control, physical rehabilitation, and the cautious use of medications, including corticosteroids and NMBAs, can help reduce the incidence of CIPNM.
authors: Cabell Huntington Hospital, 1340 Hal Greer Boulevard, Huntington, WV 25701, USA. jennifer.confer@chhi.org
authors: Jennifer
authors: J
authors: Confer
authors: Janet
authors: J
authors: Wolcott
authors: Robert
authors: R
authors: Hayes
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D016638:Critical Illness / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D007362:Intensive Care Units / Q000639:trends; D009466:Neuromuscular Blocking Agents / Q000627:therapeutic use; D011115:Polyneuropathies / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D009466:Neuromuscular Blocking Agents