Journal of Anesthesia

, Volume 29, Issue 1, pp 112–121 | Cite as

Intensive care unit-related generalized neuromuscular weakness due to critical illness polyneuropathy/myopathy in critically ill patients

  • Efstratios Apostolakis
  • Nikolaos A. Papakonstantinou
  • Nikolaos G. Baikoussis
  • George Papadopoulos
Review Article

Abstract

Thirty to fifty percent of critically ill patients admitted to the intensive care unit suffer from generalized neuromuscular weakness due to critical illness polyneuropathy, critical illness myopathy, or a combination of them, thus prolonging mechanical ventilation and their intensive care unit stay. A distinction between these syndromes and other neuromuscular abnormalities beginning either before or after ICU admission is necessary. These intensive care unit-related diseases are associated with both elevated mortality rates and increased morbidity rates. Generally, over 50 % of patients will completely recover. Most of them recover after 4–12 weeks, but some patients have been reported to keep on suffering from muscle weakness for at least 4 months. Prevention has a key role in the management of critical illness neuromuscular disorders, as no specific therapy has been suggested. Either prevention or aggressive treatment of sepsis can prevent critical illness polyneuropathy and critical illness myopathy. The dose and duration of the administration of neuromuscular blocking drugs should be limited, and their concurrent administration with corticosteroids should be avoided. Intensive insulin therapy has also been proven to reduce their incidence. Finally, early mobilization via active exercise or electrical muscle stimulation plays a significant role in their prevention.

Keywords

Critical illness Paresis Intensive care unit Muscle weakness Neuromuscular diseases Rehabilitation 

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Copyright information

© Japanese Society of Anesthesiologists 2014

Authors and Affiliations

  • Efstratios Apostolakis
    • 1
  • Nikolaos A. Papakonstantinou
    • 2
    • 5
  • Nikolaos G. Baikoussis
    • 3
  • George Papadopoulos
    • 4
  1. 1.Cardiothoracic Surgery DepartmentUniversity Hospital of Ioannina, School of MedicineIoanninaGreece
  2. 2.General Surgery DepartmentGeneral Oncological Hospital “Agioi Anargyroi”Kifisia, AthensGreece
  3. 3.Cardiac Surgery DepartmentL’Institut Mutualist MontsurisParis Cedex 14France
  4. 4.Department of AnesthesiologyUniversity Hospital of Ioannina, School of MedicineIoanninaGreece
  5. 5.AthensGreece

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