• Critical care clinics · Jan 2007

    Review

    Critical illness neuromuscular syndromes.

    • Bernard De Jonghe, Jean-Claude Lacherade, Marie-Christine Durand, and Tarek Sharshar.
    • Service de Réanimation Médico-chirurgicale, Centre Hospitalier de Poissy, 10 rue du Champ-Gaillard, 78300 Poissy, France. bdejonghe@chi-poissy-st-germain.fr
    • Crit Care Clin. 2007 Jan 1;23(1):55-69.

    AbstractCritical 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.

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