Pregledni rad
https://doi.org/10.26800/LV-145-supl4-21
Polyneuropathy and myopathy of critical illness
Sven Županić
; Zavod za neurologiju, Klinička bolnica Dubrava
Iva Markulin Antičević
Miljenko Crnjaković
Sažetak
Critical illness is any life-threatening condition wich would, without appropriate pharmacological and/or mechanical support to vital organs, lead to death. It is treated in the Intensive Care Unit (ICU). A very common complication of treatment is muscle weakness acquired in the ICU, whereby two entities are distinguished: critical illness myopathy (CIM) and critical illness polyneuropathy (CIP), and their overlapping syndrome – critical illness polymyoneuropathy (CIPNM). Clinically, they are manifested by symmetrical muscle weakness,
more pronounced in the proximal musculature, and they are suspected when patients fail to be weaned from mechanical ventilation. According to data from the literature, up to 62% of patients who fail to be weaned from the mechanical ventilation have some form of neuromuscular disease. There are various pathophysiological mechanisms in the background, from oxidative stress, mitochondrial dysfunction to changes in microcirculation caused by systemic inflammatory events. Risk factors for the aforementioned conditions are systemic inflammatory response syndrome (SIRS), sepsis, hyperglycemia, hypoalbuminemia, use of vasopressors, steroids, and neuromuscular blockers. The diagnosis is established by a combination of clinical features and the findings of electrophysiological testing. Treatment is based on treatment of the underlying disease, prevention of complications and early rehabilitation. There are data on the effectiveness of electrical muscle stimulation (EMS) in the treatment and prevention of muscle weakness acquired in the ICU. One quarter of patients have some degree of residual muscle weakness or loss of sensation when they are discharged from the hospital.
Ključne riječi
CRITICAL ILLNESS POLYNEUROPATHY; CRITICAL ILLNESS MYOPATHY; CRITICAL ILLNESS POLYNEUROMYOPATHY; SYSTEMIC INFLAMMATORY RESPONSE SYNDROME; MECHANICAL VENTILATION
Hrčak ID:
310284
URI
Datum izdavanja:
20.11.2023.
Posjeta: 339 *