Abstract
When sepsis and/or multiple organ dysfunction (MOD) complicate the course of a severe primary illness, a critical illness arises. The frequency of this syndrome has been increasing in the last years mostly because the prolonged survival of Intensive Care Units (ICU) patients due to the advent of modern methods of treatment. The incidence of the syndrome in most of ICU is between 20 and 50%. Bolton [1], in a recent review, hypothesized that infections (through sepsis) or trauma may determine the so called systemic inflammatory response syndrome (SIRS) that, in turn, determines the conditions that lead to nervous system involvement. A detailed description of mechanisms that give rise to SIRS is reported in the paper of Bolton [1]. The nervous system manifestations evolve according to a well-defined pattern [2]. Sepsis induces a septic encephalopathy that can be reverted if the sepsis is successfully treated. The subsequent difficulty in weaning the patient from the ventilator may be caused from neuropathy, myopathy, or both.
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Bolton CF (1996) Sepsis and the systemic inflammatory response syndrome: neuromuscular manifestation. Crit Care Med 24:1408–1416
Bolton CF, Young BG, Zochodne WD (1993) The neurological complications of sepsis. Ann Neurol 33:94–100
Young CF, Bolton CF, Austin TW et al (1990) The encephalopathy associated with septic illness. Clin Invest Med 13:297–304
Bolton CF (1987) Electrophysiologic studies of critically ill patients. Muscle Nerve 10:129–135
Bolton CF, Sawa GM, Carter K (1981) The effects of temperature on human compound action potentials. J Neurol Neurosurg Psychiatry 44:407–413
Flear CT, Bhattacharya SS, Singh CM (1980) Solute and water exchanges between cells and extracellular fluids in health and disturbances after trauma. J Parental Enteral Nutr 4:98–119
Rosenfalk A (1978) Early recognition of nerve disorders by near-nerve recording of sensory action potentials. Muscle Nerve 1:360–367
Bolton CF, Gilbert JJ, Hahn AF et al (1984) Polyneuropathy in critically ill patients. J Neurol Neurosurg Psychiatry 47:1223–1231
Zochodne DW, Bolton CF, Wells GA et al (1987) Critical illness polyneuropathy. A complication of sepsis and multiple organ failure. Brain 110:819–842
Markand ON, Kincaid JC, Rahman AP et al (1984) Electrophysiologic evaluation of diaphragm by transcutaneous phrenic nerve stimulation. Neurology 4:604–614
Latronico N, Fenzi F, Recupero D et al (1996) Critical illness myopathy and neuropathy. Lancet 347:1579–1582
Wijdicks EF, Fulgham JR (1994) Failure of high dose intravenous immunoglobulins to alter the clinical course of critical illness polyneuropathy. Muscle Nerve 17:1494–1495
Witt NJ, Zochodne DW, Bolton CF et al (1991) Peripheral nerve function in sepsis and multiple organ failure. Chest 99:176–184
Spitzer AR, Giancarlo T, Mäher L et al (1992) Neuromuscular causes of prolonged ventilator dependency. Muscle Nerve 15:682–686
Leijten FSS, De Weerd AW, Poortvliet DCJ et al (1996) Critical illness polyneuropathy in multiple organ dysfunction syndrome and weaning from the ventilator. Intensive Care Med 22:856–861
Schwarz J, Planck J, Briegel J et al (1997) A single-fiber electromyography, nerve conduction studies, and conventional electromyography in patients with critical-illness polyneuropathy: evidence for a lesion of terminal motor axons. Muscle Nerve 20:696–701
Barek K, Margreiter J, Willeit J et al (1996) Polyneuropathies in critically ill patients: a prospective evaluation. Intensive Care Med 22:849–855
Lopez Messa JB, Garcia A (1990) Acute polyneuropathy in critically ill patients. Intensive Care Med 16:159–162
Lejten FSS, De Weerd AW, Poortvliet DCJ et al (1995) The role of polyneuropathy in motor convalescence after prolonged mechanical ventilation. JAMA 274:1221–1225
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© 1999 Springer-Verlag Italia
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Savettieri, G., Fierro, B. (1999). Epidemiology and Diagnosis of Polyneuropathy in Critical Illness. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2145-7_49
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DOI: https://doi.org/10.1007/978-88-470-2145-7_49
Publisher Name: Springer, Milano
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