Weakness in the ICU

Green, Deborah

doi:10.1097/01.nrl.0000163784.17602.57

Cited by 34 publications

(3 citation statements)

References 59 publications

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“…acute motor axonal neuropathy and acute motor-sensory axonal neuropathy [23], may be more difficult to distinguish from CIP due to the similar clinical manifestations and EMG signs. Criteria of differentiation are specified in Table 1[24,25]. Although the clinical manifestations and EMG would not give supportive discrimination between the CIP/CIM and GBS, CSF analysis might be of help.…”

Section: Discussionmentioning

confidence: 99%

Reversible tetraplegia after percutaneous nephrostolithotomy and septic shock: a case of critical illness polyneuropathy and myopathy with acute onset and complete recovery

Kong

et al. 2013

BMC Nephrol

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BackgroundCritical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are complications causing weakness of respiratory and limb muscles in critically ill patients. As an important differential diagnosis of Guillain-Barré syndrome (GBS), CIP and CIM should be diagnosed with caution, after a complete clinical and laboratory examination. Although not uncommon in ICU, CIP and CIM as severe complications of percutaneous nephrostolithotomy (PNL) have not been documented in literature.Case presentationA 48-year-old Chinese woman was referred to our hospital, complaining of occasional pain in the right lower back for one month. Lithiasis was diagnosed by ultrasonographical and radiological examinations on the urinary system. PNL was indicated and performed. The patient developed CIP and CIM on the fourth day after PNL. Early recognition and treatment of the severe complications contributed to a satisfactory recovery of the patient.ConclusionThis case expands our understanding of the complications of PNL and underscores the importance of differentiating CIP/CIM from GBS in case of such patients developing weakness after the treatment. Clinical characteristics and examination results should be carefully evaluated to make the diagnosis of CIP or CIM. Both anti-septic prophylaxis and control of hyperglycemia might be effective for the prevention of CIP or CIM; aggressive treatment on sepsis and multiple organ failure is considered to be the most effective measure to reduce the incidence of CIP/CIM.

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Section: Discussionmentioning

confidence: 99%

Reversible tetraplegia after percutaneous nephrostolithotomy and septic shock: a case of critical illness polyneuropathy and myopathy with acute onset and complete recovery

Kong

et al. 2013

BMC Nephrol

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“…The pathophysiologic process behind CIP/CIM is not fully elucidated; reactive oxygen intermediates, drug toxicity, steroid therapy and poorly controlled hyperglycemia are considered to be critical predisposing factors [18]. Treatment options are not well validated, although intravenous immunoglobulins seem to have a beneficial effect [19]. …”

Section: Discussionmentioning

confidence: 99%

Influenza A/H1N1 septic shock in a patient with systemic lupus erythematosus. A case report

Tselios

Tsioka²,

Sarantopoulos

et al. 2011

BMC Infect Dis

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BackgroundImmunocompromised patients, such as systemic lupus erythematosus (SLE) sufferers have an increased risk of mortality, following influenza infection. In the recent pandemic, influenza A H1NI virus caused 18449 deaths, mainly because of adult respiratory distress syndrome or bacterial co-infections.Case PresentationIn this case report, an SLE patient with viral-induced septic shock, without overt pulmonary involvement, is discussed. The patient was administered oseltamivir and supportive treatment, including wide-spectrum antibiotics, vasopressors and steroids, according to the guidelines proposed for bacterial sepsis and septic shock. She finally survived and experienced a lupus flare soon after intensive care unit (ICU) discharge.ConclusionsTo our knowledge, this is the first case to report severe septic shock from influenza A/H1N1 virus, without overt pulmonary involvement.

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“…Furthermore, a nerve biopsy and detection of anti-ganglioside antibodies could be helpful in differentiating critical illness polyneuropathy from axonal Guillain-Barré syndrome[15]. The criteria for differentiation are specified in Table 2[8081]. …”

Section: Differential Diagnosesmentioning

confidence: 99%

Critical illness polyneuropathy and myopathy: a systematic review

et al. 2014

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Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles, respectively. Clinically, they manifest as limb and respiratory muscle weakness. Critical illness polyneuropathy/myopathy in isolation or combination increases intensive care unit morbidity via the inability or difficulty in weaning these patients off mechanical ventilation. Many patients continue to suffer from decreased exercise capacity and compromised quality of life for months to years after the acute event. Substantial progress has been made lately in the understanding of the pathophysiology of critical illness polyneuropathy and myopathy. Clinical and ancillary test results should be carefully interpreted to differentiate critical illness polyneuropathy/myopathy from similar weaknesses in this patient population. The present review is aimed at providing the latest knowledge concerning the pathophysiology of critical illness polyneuropathy/myopathy along with relevant clinical, diagnostic, differentiating, and treatment information for this debilitating neurological disease.

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Weakness in the ICU

Cited by 34 publications

References 59 publications

Reversible tetraplegia after percutaneous nephrostolithotomy and septic shock: a case of critical illness polyneuropathy and myopathy with acute onset and complete recovery

Reversible tetraplegia after percutaneous nephrostolithotomy and septic shock: a case of critical illness polyneuropathy and myopathy with acute onset and complete recovery

Influenza A/H1N1 septic shock in a patient with systemic lupus erythematosus. A case report

Critical illness polyneuropathy and myopathy: a systematic review

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