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Nerve Ultrasound Protocol to Detect Dysimmune Neuropathies
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Critical illness polyneuromyopathy.

Jennifer Confer1, Janet Wolcott, Robert Hayes

  • 1Cabell Huntington Hospital, 1340 Hal Greer Boulevard, Huntington, WV 25701, USA. jennifer.confer@chhi.org

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|July 5, 2012
PubMed
Summary
This summary is machine-generated.

Critical illness polyneuromyopathy (CIPNM) is a common sensory-motor neuropathy in critically ill patients. While no specific treatments exist, prevention through nutrition, glucose control, and rehabilitation can reduce its incidence.

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Area of Science:

  • Neurology
  • Critical Care Medicine

Background:

  • Critical illness polyneuromyopathy (CIPNM) is a frequent complication in intensive care units, affecting a significant percentage of critically ill adult patients.
  • It is characterized as an acute axonal sensory-motor polyneuropathy often developing after respiratory insufficiency in patients with systemic inflammatory response syndrome, sepsis, or multiple-organ dysfunction syndrome.

Purpose of the Study:

  • To review the clinical characteristics and treatment strategies for critical illness polyneuromyopathy (CIPNM).

Main Methods:

  • Review of clinical characteristics and treatment approaches for CIPNM.
  • Discussion of diagnostic methods including electrophysiologic studies (electromyography, electroneurography) and biopsies.
  • Analysis of preventive measures and their impact on CIPNM incidence.

Main Results:

  • CIPNM is an acute axonal sensory-motor polyneuropathy prevalent in critically ill patients with sepsis and multiorgan failure.
  • An estimated 25-85% of critically ill adult patients develop neuromuscular weakness, most commonly CIPNM.
  • No specific pharmacologic treatments are currently available for CIPNM.

Conclusions:

  • Patient outcomes are linked to the severity of the underlying illness and neuromyopathy, emphasizing the importance of early intervention.
  • Preventive strategies, including early nutrition, glucose control, physical rehabilitation, and judicious use of corticosteroids and neuromuscular blocking agents (NMBAs), can mitigate CIPNM occurrence.
  • Electrophysiologic studies are considered the gold standard for aiding in CIPNM diagnosis.