The Open Critical Care Medicine Journal

2011, 4 : 8-14
Published online 2011 July 07. DOI: 10.2174/1874828701104010008
Publisher ID: TOCCMJ-4-8

Neurological Sequelae of Sepsis: II) Neuromuscular Weakness

Hubertus Axer , Bernd F.M. Romeike , Frank Brunkhorst , Jan Zinke , Thomas M. Ringer and Albrecht Günther
Hans Berger Clinic for Neurology, Jena University Hospital, Friedrich-Schiller-University Jena, Erlanger Allee 101, D-07747 Jena, Germany.

ABSTRACT

Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) have been established as separate entities of muscular weakness in critically ill patients, although both may be associated to each other in some respects. Both are associated to systemic inflammatory response syndrome, sepsis, and severe sepsis. Major signs of nerve and muscle disturbances in critically ill patients are muscle weakness and problems of weaning from the ventilator. Electroneurographic measurements help to detect CIP early in the course of the disease, while muscle biopsy seems to date the diagnostic tool of choice to detect CIM. Sepsis therapy is the major target to prevent the development of CIP and CIM. However, no specific therapy of CIP and CIM has been established in the past. Therefore, management of patients with CIP and CIM is mainly supportive. Neuromuscular weakness cause elongated times of ventilation, elongated hospital stay, elongated times of rehabilitation, and increased mortality. This review provides an overview of clinical and diagnostic features of CIP and CIM, and summarizes current pathophysiological and therapeutic concepts.

Keywords:

Sepsis, critical illness polyneuropathy, critical illness myopathy, neuromuscular weakness.