[Neuromuscular complications of sepsis]

Neuromuscular complications are common in patients treated for sepsis and multiple organ dysfunction in critical care units. Failure to wean from the ventilator, due to involvement of the respiratory system, and severe muscular weakness are typical symptoms. Electrophysiological examination demonstrates fibrillation potentials and reduction of compound muscular action potential amplitudes.

We report three patients with severe muscular weakness during treatment of critical illness.

Critical illness polyneuropathy was the main cause of weakness in two patients, with a presumed superimposed myopathy in one. A third patient had critical illness myopathy.

Critical illness polyneuropathy and myopathy--either as separate or combined entities--are common causes of muscular weakness during treatment of critical illness. These disorders are often difficult to distinguish from each other, as the clinical and electrophysiological findings may overlap. Sepsis and multiple organ dysfunction are the main aetiological factors, but certain drugs may contribute in the pathogenesis. No specific treatment exists. In the most severe cases long-lasting physiotherapy and rehabilitation is needed.