title: Critical illness polyneuropathy (CIP) in neurological early rehabilitation: clinical and neurophysiological features.
abstract: BACKGROUND
  Critical illness polyneuropathy (CIP) is a complex disease affecting 30-70% of critically ill patients.
  
  
  METHODS
  Clinical (Barthel index, length of stay (LOS), morbidity, duration of mechanical ventilation, routine lab results) and neurophysiological (neurography) data of 191 patients admitted to neurological early rehabilitation and diagnosed with CIP have been analyzed retrospectively.
  
  
  RESULTS
  CIP diagnosis was correct in 159 cases (83%). In this study, systemic inflammation, sepsis, systemic inflammatory response syndrome (SIRS), multiple organic failure (MOF), chronic renal failure, liver dysfunction, mechanical ventilation, diabetes, dyslipidemia and impaired ion homeostasis (hypocalcaemia, hypokalemia) were associated with CIP. Neurography, in particular of the peroneal, sural, tibial and median nerves, helped to identify CIP patients. Compound muscle action potential amplitude (r = -0.324, p < 0.05), as well as sensory (r = -0.389, p < 0.05) and motor conduction velocity (r = -0.347, p < 0.05) of the median nerve correlated with LOS in neurological early rehabilitation but not with outcome measures.
  
  
  CONCLUSIONS
  In most cases, diagnosis of CIP among neurological early rehabilitation patients seems to be correct. Neurography may help to verify the diagnosis and to learn more about CIP pathophysiology, but it does not allow outcome prediction. Further studies on CIP are strongly encouraged.
authors.affiliation: Institute for Neurorehabilitation Research (InFo), Hannover Medical School, BDH-Clinic Hessisch Oldendorf, Greitstr. 18-28, Hessisch Oldendorf, 31840, Germany.
authors.forename: Simone B
authors.initials: SB
authors.lastname: Schmidt
authors.affiliation: Institute for Neurorehabilitation Research (InFo), Hannover Medical School, BDH-Clinic Hessisch Oldendorf, Greitstr. 18-28, Hessisch Oldendorf, 31840, Germany. prof.rollnik@bdh-klinik-hessisch-oldendorf.de.
authors.forename: Jens D
authors.initials: JD
authors.lastname: Rollnik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000066530:Neurological Rehabilitation; D017063:Outcome Assessment, Health Care; D011115:Polyneuropathies / Q000175:diagnosis* / Q000503:physiopathology* / Q000534:rehabilitation; D011379:Prognosis; D012189:Retrospective Studies
keywords: CIP; Critical illness polyneuropathy; Diagnosis; Early rehabilitation; Outcome; Pathophysiology