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Critical illness polyneuromyopathy after artificial respiration
A A Op de Coul1, G A Verheul, A C Leyten
1Department of Neurology, St. Elisabeth Hospital, Tilburg, The Netherlands.
Clinical Neurology and Neurosurgery
|January 1, 1991
Summary
Critically ill patients on artificial respiration may develop severe neuromuscular complications like flaccid tetraparesis and muscle atrophy. Prognosis is good for survivors, with causes including polyneuropathy, myopathy, and possibly tumor necrosis factor.
Area of Science:
- Intensive Care Medicine
- Neurology
- Pathology
Background:
- Neuromuscular complications are reported in critically ill patients undergoing artificial respiration.
- A significant number of patients develop severe flaccid tetraparesis and muscle atrophy after prolonged mechanical ventilation.
Purpose of the Study:
- To review the literature on neuromuscular complications post-artificial respiration.
- To present data from a series of patients with these complications.
- To discuss the potential causes of these neuromuscular issues.
Main Methods:
- Literature review on neuromuscular complications after artificial respiration.
- Analysis of a personal series of 22 patients with severe neuromuscular deficits.
- Discussion of contributing factors, including polyneuropathy, myopathy, and inflammatory mediators.
Main Results:
- 22 patients developed severe flaccid tetraparesis and muscle atrophy after an average of two weeks of artificial respiration.
- The prognosis for surviving patients with the primary critical illness was relatively good.
- Multiconditional causes were identified, emphasizing a combination of polyneuropathy and myopathy.
Conclusions:
- Neuromuscular complications are a significant concern in patients requiring artificial respiration.
- Polyneuropathy and myopathy are key contributors to these complications.
- Tumor necrosis factor (TNF) is a potential etiological factor due to its role in sepsis and impact on muscle and nerves.