Neuromuscular Disorders in critically ill patients In ICU

Abstract

Neuromuscular abnormalities developing as a consequence of critical illness can be found in the majority of patients in the intensive care unit for 6 days or more. The spectrum of illness ranges from isolated nerve entrapment with focal pain or weakness, to disuse muscle atrophy with mild weakness, to severe myopathy or neuropathy with associated severe prolonged weakness. A broad classification of ICU-acquired neuromuscular disorders exist, the most important are CINMP and ICU-AW. Several processes during critical illness may promote such weakness, These include sepsis-related inflammation, immobilization, the endocrine stress responses, the rapidly developing nutritional deficit, microvascular alterations, metabolic alterations and electrical alternations in critical illness. ICU-AW complicate recovery and outcome of patients on short term and long term causing disability, prolonged hospital stay, increased Cost and mortality. Prevention of ICUAW is the definitive management strategy by minimizing sedation and neuromuscular blocking agents. Good glycemic and Sepsis control as well as an emphasis on early mobilization, rehabilitation and physiotherapy in the critically ill as fast as possible.