title: Treatment of critical illness polyneuropathy and/or myopathy - a systematic review.
abstract: BACKGROUND
  The objective was to search the literature with a view to providing a general description of critical illness myopathy/polyneuropathy (CIM/CIP), including its genesis and prevention. Furthermore, it was our aim to determine whether new treatments have occurred in the past five years.
  
  
  METHODS
  PubMed, Cinahl and Swedmed+ were searched using the terms CIM, CIP and intensive care. The search was narrowed by adding the limits: humans, English, Danish, Norwegian, Swedish and, furthermore, articles had to have been published in the past five years as we aimed to focus on new knowledge.
  
  
  RESULTS
  A total of 74 articles were found. We excluded articles focusing on children and intensive care, tight insulin therapy in patients without CIM/CIP and articles focusing on Guillain-Barré syndrome, triage, bleeding, alcohol or meningitis. Of the remaining 36 articles, only five focused on CIM/CIP treatment. Their relevant original references were found and used too.
  
  
  CONCLUSIONS
  CIM/CIP is the most commonly occurring intensive care unit (ICU)-acquired neuromuscular dysfunction, and it is associated with a significant increase in length of stay, delayed weaning from mechanical ventilation, prolonged rehabilitation and, consequently, more expenses. To treat/prevent this condition, it seems reasonable to ensure maximal functional status for survivors of an ICU-stay by applying a multimodal therapeutic approach that includes intensive insulin therapy, minimal sedation and, as suggested by new evidence, early physiotherapy and electrical muscle stimulation.
authors.affiliation: Department of Anesthesiology and Intensive Care, Glostrup Hospital, Denmark. mogens@ydemann.dk
authors.forename: Mogens
authors.initials: M
authors.lastname: Ydemann
authors.forename: Heidi Shil
authors.initials: HS
authors.lastname: Eddelien
authors.forename: Anne Øberg
authors.initials: AØ
authors.lastname: Lauritsen
mesh_terms: D003422:Critical Care / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D009135:Muscular Diseases / Q000628:therapy*; D011115:Polyneuropathies / Q000628:therapy*