Critical Illness Polyneuropathy

Aka: Critical Illness Polyneuropathy, Neuropathy Following ICU Admission

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II. Pathophysiology

  1. Neurogenic atrophy and axonal degeneration results in acute motor and sensory denervation
  2. Results in leg and respiratory Muscle Weakness

III. Risk Factors

  1. Prolonged ICU Admission
  2. Sepsis
  3. Multiorgan Failure
  4. Hyperglycemia

IV. Diagnosis

  1. Similar diagnostic criteria for Myopathy Following ICU Admission
  2. Limb Weakness AND
  3. Unexplained difficult mechanical Ventilator Weaning

V. Management

  1. Physical rehabilitation
    1. No current evidence to support for confirmed Polyneuropathy (and no Myopathy)
    2. Contrast with Myopathy Following ICU Admission in which physical therapyis effective
  2. Neuropathic pain management
    1. Capsaicin Cream
    2. Anticonvulsants such as Gabapentin (Neurontin) or Pregabalin (Lyrica)
    3. Selective Serotonin Reuptake Inhibitors (SSRI)
    4. Serotonin Norepinephrine Reuptake Inhibitors such as Venlafaxine (Effexor) or Duloxetine (Cymbalta)

VI. Course

  1. Nerve function improves as medical disorders improve, but weakness and numbness may persist
  2. Resolves in most cases within 3 years of ICU discharge

VII. Prevention

  1. Early mobilization in ICU improves mobility and strength

VIII. References

  1. Bolton (2001) Crit Care Med 29(12):2388-90 [PubMed]
  2. Volk (2009) Am Fam Physician 79(6): 459-64 [PubMed]
  3. Wilbur (2021) Am Fam Physician 103(10): 590-6 [PubMed]

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Related Studies

Ontology: Polyneuropathy, Critical Illness (C0393851)

Concepts Disease or Syndrome (T047)
MSH D011115
ICD9 357.82
ICD10 G62.81
SnomedCT 230594005
English Crit illness-assoc polyneurop, Critical illness polyneuropath, polyneuropathy due to critical illness (diagnosis), polyneuropathy due to critical illness, Critical Illness Polyneuropathies, Polyneuropathies, Critical Illness, Critical Illness Polyneuropathy, Crit illness neuropathy, critical illness polyneuropathy, Critical illness polyneuropathy, Critical illness-associated polyneuropathy, Critical illness polyneuropathy (disorder), Polyneuropathy, Critical Illness
Dutch kritieke ziekte neuropathie
French Polyneuropathie de maladie critique, Polyneuropathie associée à un état critique
German Critical Illness-Neuropathie
Italian Polineuropatia in condizioni cliniche critiche, Polineuropatia in condizioni critiche
Portuguese Polineuropatia de doença crítica
Spanish Polineuropatía del paciente crítico, enfermedad crítica con polineuropatía (trastorno), enfermedad crítica con polineuropatía
Japanese 重症疾患多発ニューロパチー, ｼﾞｭｳｼｮｳｼｯｶﾝﾀﾊﾂﾆｭｰﾛﾊﾟﾁｰ
Czech Polyneuropatie u kritické choroby, polyneuropatie kriticky nemocných
Hungarian Polyneuropathia kritikus betegségben
Norwegian Polynevropati ved kritisk sykdom
Derived from the NIH UMLS (Unified Medical Language System)

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