• Shawn J Bird.
• Shawn J. Bird, MD Department of Neurology, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. shawn.bird@uphs.upenn.edu.
• Curr Treat Option Ne. 2007 Mar 1; 9 (2): 85-92.

AbstractNewly acquired neuromuscular weakness commonly develops in the setting of critical illness. This weakness delays recovery and often causes prolonged ventilator dependence. An axonal sensory-motor polyneuropathy, critical illness polyneuropathy (CIP), is seen in up to a third of critically ill patients with the systemic inflammatory response syndrome (usually due to sepsis). As frequently, or more so, an acute myopathy, critical illness myopathy (CIM), develops in a similar setting, often in association with the use of corticosteroids and/or nondepolarizing neuromuscular-blocking agents. This paper reviews the clinical features, diagnostic approach, and treatment of CIP and CIM. There are no specific pharmacologic treatments for CIP or CIM, but recognizing the presence of one of these disorders often improves management. Prevention of CIP and CIM is feasible in part by avoiding risk factors and by aggressive medical management of critically ill patients. Intensive insulin therapy in intensive care unit patients appears to reduce the likelihood of developing CIP and/or CIM. Future treatments of sepsis may further reduce the incidence of these neuromuscular consequences of critical illness.

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