[Critical illness myopathy and polyneuropathy].

Area of Science:

• Neurology
• Intensive Care Medicine
• Rehabilitation

Background:

• Neuromuscular dysfunction, including critical illness polyneuropathy and myopathy, affects a significant majority of intensive care unit (ICU) patients.
• The term intensive care unit-acquired weakness (ICUAW) is now preferred to describe these conditions, encompassing both nerve and muscle damage.
• While pure myopathy is common, pure neuropathy is rare, with mixed forms occurring in 30-50% of cases.

Purpose of the Study:

• To review the incidence, risk factors, and long-term consequences of intensive care unit-acquired weakness (ICUAW).
• To highlight the distinction between myopathy and neuropathy components of ICUAW and their differential impact on patient recovery.
• To emphasize the prevalence and persistence of functional impairments following ICU stays.

Main Methods:

• Literature review of studies on neuromuscular complications in critically ill patients.
• Analysis of risk factors associated with the development of ICUAW, such as sepsis, multiorgan dysfunction, and ARDS.
• Examination of the long-term sequelae of ICUAW, including paralysis, sensory disturbances, and balance problems.

Main Results:

• 50-80% of ICU patients experience neuromuscular disturbances, broadly termed ICUAW.
• Sepsis, multiorgan dysfunction, and acute respiratory distress syndrome (ARDS) are key risk factors for ICUAW development.
• Approximately one-third of patients have persistent impairments upon ICU discharge, with 10% experiencing long-term issues, primarily linked to the neuropathic component.

Conclusions:

• Intensive care unit-acquired weakness (ICUAW) is a prevalent complication with significant long-term functional consequences for patients.
• The neuropathic component of ICUAW is particularly associated with persistent paralysis and balance disturbances.
• Early identification and management of risk factors are crucial to mitigate the long-term impact of ICUAW on patient recovery and quality of life.