Neuromuscular abnormalities in critical illness

Critical illness neuromuscular abnormalities (CINMA) are found in 25 percent of ITU patients who recover consciousness and are characterized by a bilateral and symmetric weakness that involves the four limbs but spares the facial muscles. Electrophysiological testing shows an axonal sensory motor po...

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Bibliographic Details
Published in:Revue neurologique 2005-12, Vol.161 (12 Pt 1), p.1267
Main Authors: Louillet, F, Colas, F, Outin, H D, De Jonghe, B, Sharshar, T
Format: Article
Language:fre
Subjects:
Critical Care
Critical Illness
Humans
Peripheral Nervous System Diseases - diagnosis
Peripheral Nervous System Diseases - etiology
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Summary:Critical illness neuromuscular abnormalities (CINMA) are found in 25 percent of ITU patients who recover consciousness and are characterized by a bilateral and symmetric weakness that involves the four limbs but spares the facial muscles. Electrophysiological testing shows an axonal sensory motor polyneuropathy and/or myopathy. The main risk factors of CINMA are prolonged durations of multiple organ failure and mechanical ventilation, use of corticosteroids and hyperglycaemia. CINMA contribute also to increase the duration of mechanical ventilation, this effect being mediated by diaphragm weakness. The median duration of limb weakness is 21 days, although it can exceed several months in some patients. Few preventive measures have been assessed. Whether the benefit of strict blood glucose control in ITU patients recovering from heart surgery on CINMA incidence can be extended to medical ICU patients needs to be determined.
ISSN:0035-3787