Critical illness neuromyopathy (CINM) is a common yet frequently overlooked complication in intensive care units (ICU). CINM often results in prolonged ventilator dependence and persistent limb weakness, significantly impacting patient recovery and long-term quality of life. CINM can be categorized into two primary subtypes: critical illness polyneuropathy (CIP) and critical illness myopathy (CIM). These conditions frequently arise in the context of severe sepsis, multiple organ failure, or as adverse effects of certain medications used in the ICU. This review aims to provide a concise overview of CINM, focusing on its pathophysiology, diagnostic approaches, and current clinical management strategies.
The field of critical care medicine has flourished, but an unfortunate result of improved patient survival in the intensive care unit is the occurrence of certain acquired neuromuscular disorders. During the lase two decades, various neuromuscular disorders were recognized as common cause of weakness occurring in critically ill patients. The two most common disorders are an acute quadriplegic myopathy predominantly associated with the use of intravenous corticosteroids and neuromuscular junction blocking agents and severe systemic illness termed critical illness myopathy(CIM), and an axonal sensorimotor polyneuropathy termed critical illness polyneuropathy. I will review briefly about general components of the CIM.
Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) occur commonly in the patients who havebeen on mechanical ventilation for more than 1 week. Even in some patients diagnosed with CIP, an underlyingmyopathy may be the primary cause of the muscle weakness. The cormorbid status of CIP and CIM is called as criticalillness polyneuropathy and critical illness myopathy (CIPNM). We describe a 56-year-old man with acute quadriparesisand areflexia after systemic inflammatory response syndrome. The diagnosis of CIPNM is important to avoid unnecessaryinvestigations and unreasonably pessimistic prognosis. Electrophysiologic studies are essential for the diagnosis and forplanning further clinical management.