Critical illness neuromuscular syndromes

Area of Science:

• Neurology
• Critical Care Medicine
• Electrophysiology

Background:

• Critical illness neuromyopathy (CINM) presents as limb weakness post-critical illness.
• It often involves both peripheral nerves and muscles, but isolated muscle involvement is increasingly recognized.
• CINM commonly affects respiratory muscles, leading to prolonged mechanical ventilation.

Purpose of the Study:

• To summarize the understanding of CINM.
• To highlight electrophysiologic findings in CINM.
• To identify risk factors and potential preventive strategies for CINM.

Main Methods:

• Review of electrophysiologic investigations, including direct muscle stimulation.
• Analysis of risk factors associated with CINM.
• Discussion of clinical presentation and consequences of CINM.

Main Results:

• Electrophysiology increasingly identifies isolated muscle involvement in CINM.
• CINM is linked to muscle immobilization and sepsis-induced multiorgan failure.
• Hyperglycemia and corticosteroid use may negatively impact the neuromuscular system in critically ill patients.

Conclusions:

• CINM is a significant complication of critical illness.
• Early identification of risk factors like hyperglycemia and corticosteroid use is crucial.
• Preventive interventions targeting these factors may improve outcomes for critically ill patients.