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Updated: Mar 10, 2026
Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
Critical illness polyneuropathy (CIP) in neurological early rehabilitation: clinical and neurophysiological features
Simone B Schmidt1, Jens D Rollnik2
1Institute for Neurorehabilitation Research (InFo), Hannover Medical School, BDH-Clinic Hessisch Oldendorf, Greitstr. 18-28, Hessisch Oldendorf, 31840, Germany.
Background:
Critical illness polyneuropathy (CIP) is a complex disease affecting 30-70% of critically ill patients.
Methods:
Clinical (Barthel index, length of stay (LOS), morbidity, duration of mechanical ventilation, routine lab results) and neurophysiological (neurography) data of 191 patients admitted to neurological early rehabilitation and diagnosed with CIP have been analyzed retrospectively.
Results:
CIP diagnosis was correct in 159 cases (83%). In this study, systemic inflammation, sepsis, systemic inflammatory response syndrome (SIRS), multiple organic failure (MOF), chronic renal failure, liver dysfunction, mechanical ventilation, diabetes, dyslipidemia and impaired ion homeostasis (hypocalcaemia, hypokalemia) were associated with CIP. Neurography, in particular of the peroneal, sural, tibial and median nerves, helped to identify CIP patients. Compound muscle action potential amplitude (r = -0.324, p < 0.05), as well as sensory (r = -0.389, p < 0.05) and motor conduction velocity (r = -0.347, p < 0.05) of the median nerve correlated with LOS in neurological early rehabilitation but not with outcome measures.
Conclusions:
In most cases, diagnosis of CIP among neurological early rehabilitation patients seems to be correct. Neurography may help to verify the diagnosis and to learn more about CIP pathophysiology, but it does not allow outcome prediction. Further studies on CIP are strongly encouraged.
