Critical illness polyneuromyopathy

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Abstract

Critical illness polyneuromyopathy is acquired neuromuscular abnormalities (polyneuropathy and/or myopathy) as a result of critical illness with prolonged immobilization, clinically manifesting with muscle weakness and difficult weaning from mechanical ventilation. In review present up-to-date information about history, epidemiology, etiology, pathogenesis, clinical picture, diagnostics, differential diagnosis, disease course, prevention and treatment of critical illness polyneuromyopathy.

 

About the authors

A. M. Alasheev

Clinical Institute of the Brain of Ural State Medical Academy

Author for correspondence.
Email: alasheev@gkb40.ur.ru
Russian Federation, Ekaterinburg

A. A. Belkin

Clinical Institute of the Brain of Ural State Medical Academy

Email: alasheev@gkb40.ur.ru
Russian Federation, Ekaterinburg

B. D. Zislin

Clinical Institute of the Brain of Ural State Medical Academy

Email: alasheev@gkb40.ur.ru
Russian Federation, Ekaterinburg, Russia

References

  1. Алашеев А.М. Синдром нервно-мышечных нарушений при критическом состоянии в нейрореаниматологии: Автореф. дис. канд. мед. наук. Екатеринбург: Издательство УрГУ, 2006.
  2. Алашеев А.М., Белкин А.А. Опыт применения ипидакрина для лечения нервно-мышечных нарушений критического состояния. Вестн. Урал. мед. академ. науки. 2009; 1: 54–56.
  3. Белкин А.А, Алашеев А.М. Нервно-мышечные нарушения при критическом состоянии в нейрореаниматологии. Интенсивная терапия. 2006; 3: 195–199.
  4. Белкин А.А., Алашеев А.М. Полинейромиопатия у больных в интенсивной терапии. В кн.: Гельфанд Б.Р., Салтанов А.И. (ред.) Интенсивная терапия: национальное руководство. В 2-х томах. M.: ГЭОТАР-Медиа, 2009.
  5. Кузин М.И., Гехт Б.М. Миастения. М.: Медицина; 1996.
  6. Невропатии при острой порфирии. В кн.: Жулев Н.А. (ред.) Невропатии: Руководство для врачей. СПб.: Издательский дом СПбМАПО, 2005.
  7. Пирадов М.А. Синдром Гийена-Барре. М.: Интермедика, 2003.
  8. Ahlbeck K., Fredriksson K., Rooyackers O. et al. Signs of critical illness polyneuropathy and myopathy can be seen early in the ICU course. Acta Anaesthesiol. Scand. 2009; 53: 717–723.
  9. Ali N.A., O’Brien J.M.Jr., Hoffmann S.P. et al. Acquired weakness, handgrip strength, and mortality in critically ill patients. Am. J. Respir. Crit. Care Med. 2008; 178: 261–268.
  10. Allen D.C., Arunachalam R., Mills K.R. Critical illness myopathy: further evidence from muscle-fiber excitability studies of an acquired channelopathy. Muscle & nerve. 2008; 37: 14–22.
  11. Ayas N.T., McСool F.D., Gore R. et al. Prevention of human diaphragm atrophy with short periods of electrical stimulation. Am. J. Respir. Crit. Care Med. 1999; 159: 2018–2020.
  12. Bailey P., Thomsen G.E., Spuhler V.J. et al. Early activity is feasible and safe in respiratory failure patients. Crit. Care Med. 2007; 35: 139–145.
  13. Banwell B.L., Mildner R.J., Hassall A.C. et al. Muscle weakness in critically ill children. Neurology. 2003; 61: 1779–1782.
  14. Bednarík J., Vondracek P., Dusek L. et al. Risk factors for critical illness polyneuromyopathy. J. Neurol. 2005; 252: 343–351.
  15. Blackwood B., Alderdice F., Burns K.E. et al. Protocolized vs. nonprotocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients: Cochrane review protocol. J. Adv. Nurs. 2009; 65: 957–964.
  16. Boles J., Bion J., Connors A. et al. Weaning from mechanical ventilation. Eur. Respir. J. 2007; 29: 1033–1056.
  17. Bolton C.F. AAEM minimonograph #40: clinical neurophysiology of the respiratory system. Muscle Nerve. 1993; 16: 809–818.
  18. Bolton C.F. Neuromuscular manifestations of critical illness. Muscle Nerve. 2005; 32: 140–163.
  19. Bolton C.F., Gilbert J.J., Hahn A.F., Sibbald W.J. Polyneuropathy in critically ill patients. J. Neurol. Neurosurg. Psychiatry 1984; 47: 1223–1231.
  20. Bolton C.F., Laverty D.A., Brown J.D. et al. Critically ill polyneuropathy: electrophysiological studies and differentiation from Guillain-Barré syndrome. J. Neurol. Neurosurg. Psychiatry. 1986; 49: 563–573.
  21. Bolton C., Thompson J., Bernardi L. et al. The cardiac R-R variation and sympathetic skin response in the intensive care unit. Can J Neurol Sci. 2007; 34: 313–315.
  22. Boon A.J., Alsharif K.I., Harper C.M., Smith J. Ultrasound-guided needle EMG of the diaphragm: technique description and case report. Muscle Nerve. 2008; 38: 1623–1626.
  23. Burton C., Clerckx B., Roberts C. et al. Early exercise in critically ill patients enhances short-term functional recovery. Crit. Care Med. 2009; 37: 2499–2505.
  24. Campellone J.V., Lacomis D., Kramer D.J. et al. Acute myopathy after liver transplantation. Neurology. 1998; 50: 46–53.
  25. Cankayali I., Dogan Y.H., Solak I. et al. Neuromuscular deterioration in the early stage of sepsis in rats. Crit. Care. 2007; 11: R1.
  26. Carls G., Ziemann U., Kunkel M., Reimers C.D. Electrical and magnetic stimulation of the intercostal nerves: a comparative study. Electromyogr. Clin. Neurophysiol. 1997; 37: 509–512.
  27. Chiang L., Wang L., Wu C. et al. Effects of physical training on functional status in patients with prolonged mechanical ventilation. Phys. Ther. 2006; 86: 1271–1281.
  28. Coakley J.H., Nagendran K., Honavar M., Hinds C.J. Preliminary observations on the neuromuscular abnormalities in patients with organ failure and sepsis. Intensive Care Med. 1993; 19: 323–328.
  29. Coakley J.H., Nagendran K., Yarwood G.D. et al. Patterns of neurophysiological abnormality in prolonged critical illness. J. Neurol. 1998; 24: 801–807.
  30. De Jonghe B., Bastuji-Garin S., Durand M. et al. Respiratory weakness is associated with limb weakness and delayed weaning in critical illness. Crit. Care Med. 2007; 35: 2007–2015.
  31. De Jonghe B., Bastuji-Garin S., Sharshar T. et al. Does ICUacquired paresis lengthen weaning from mechanical ventilation? Intensive Care Med. 2004; 30: 1117–1121.
  32. De Jonghe B., Sharshar T., Durand-Zaleski I. et al. Paresis acquired in the intensive care unit: a prospective multicenter study. JAMA. 2002; 288: 2859–2867.
  33. De Letter M.A., Schmitz P.I., Visser L.H. et al. Risk factors for the development of polyneuropathy and myopathy in critically ill patients. Crit. Care Med. 2001; 29: 2281–2286.
  34. De Letter M.A., Visser L.H., van Der Meché F.G. et al. Distinctions between critical illness polyneuropathy and axonal Guillain-Barré syndrome. J. Neurol. Neurosurg. Psychiatry 2000; 68: 397–398.
  35. Ferrando A.A., Lane H.W., Stuart C.A. et al. Prolonged bed rest decreases skeletal muscle and whole body protein synthesis. Am. J. Physiol. 1996; 270: E627–E633.
  36. Fink H., Helming M., Unterbuchner C. et al. Systemic inflammatory response syndrome increases immobility-induced neuromuscular weakness. Crit. Care Med. 2008; 36: 910–916.
  37. Fletcher S.N., Kennedy D.D. et al. Persistent neuromuscular and neurophysiologic abnormalities in long-term survivors of prolonged critical illness. Crit. Care Med. 2003; 31: 1012–1016.
  38. Friedrich O. Critical illness myopathy: sepsis-mediated failure of the peripheral nervous system. Eur. J. Anaes. Suppl. 2008; 42: 73–82.
  39. Garnacho-Montero J., Amaya-Villar R., García-Garmendía J.L. et al. Effect of critical illness polyneuropathy on the withdrawal from mechanical ventilation and the length of stay in septic patients. Crit. Care Med. 2005; 33: 349–354.
  40. Garnacho-Montero J., Madrazo-Osuna J., García-Garmendía J.L. et al. Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients. Intensive Care Med. 2001; 27: 1288–1296.
  41. Girard K., Raffin T.A. The chronically critically ill: to save or let die? Respir. Care 1985; 30: 339–347.
  42. Goligher E., Ferguson N.D. Mechanical ventilation: epidemiological insights into current practices. Curr. Opin. Crit. Care 2009; 15: 44–51.
  43. Gosselink R., Bott J., Johnson M. et al. Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients. Intensive Care Med. 2008; 34: 1188–1199.
  44. Griffiths R.D., Palmer T.E., Helliwell T. et al. Effect of passive stretching on the wasting of muscle in the critically ill. Nutrition. 1996; 11: 428–432.
  45. Guarneri B., Bertolini G., Latronico N. Long-term outcome in patients with critical illness myopathy or neuropathy: the Italian multicentre CRIMYNE study. J. Neurol. Neurosurg. Psychiatry. 2008; 79: 838–841.
  46. Gutmann L., Blumenthal D., Schochet S.S. Acute type II myofiber atrophy in critical illness. Neurology. 1996; 46: 819–821.
  47. Helliwell T.R., Wilkinson A., Griffiths R.D. et al. Muscle fibre atrophy in critically ill patients is associated with the loss of myosin filaments and the presence of lysosomal enzymes and ubiquitin. Neuropathol. Appl. Neurobiol. 1998: 507–517.
  48. Hermans G., De Jonghe B., Bruyninckx F., Berghe G. Clinical review: Critical illness polyneuropathy and myopathy. Crit. Care. 2008; 12: 238.
  49. Hermans G., De Jonghe B., Bruyninckx F., Van Den Berghe G. Interventions for preventing critical illness polyneuropathy and critical illness myopathy. Cochrane database of systematic reviews. 2009; 1:CD006832.
  50. Hermans G., Wilmer A., Meersseman W. et al. Impact of Intensive Insulin Therapy on Neuromuscular Complications and Ventilator Dependency in the Medical Intensive Care Unit. Am. J. Respir. Crit. Care Med. 2006; 175: 480–489.
  51. Hirano M., Ott B.R., Raps E.C. et al. Acute quadriplegic myopathy: a complication of treatment with steroids, nondepolarizing blocking agents, or both. Neurology. 1992; 42: 2082–2087.
  52. Hollander J.M., Mechanick J.I. Nutrition support and the chronic critical illness syndrome. Nutr. Clin. Pract. 2006; 21: 587–604.
  53. Hough C.L., Steinberg K.P., Taylor Thompson B. et al. Intensive care unit-acquired neuromyopathy and corticosteroids in survivors of persistent ARDS. Intensive Care Med. 2009; 35: 63–68.
  54. Hund E.F., Fogel W., Krieger D. et al. Critical illness polyneuropathy: clinical findings and outcomes of a frequent cause of neuromuscular weaning failure. Crit. Care Med. 1996; 24: 1328–1333.
  55. Juel V.C., Massey J.M. Myasthenia gravis. Orphanet J. Rare Dis. 2007; 2: 44.
  56. Khan J., Harrison T.B., Rich M.M., Moss M. Early development of critical illness myopathy and neuropathy in patients with severe sepsis. Neurology 2006; 67: 1421–1425.
  57. Latronico N., Fenzi F., Recupero D. et al. Critical illness myopathy and neuropathy. Lancet. 1996; 347: 1579–1582.
  58. Latronico N., Shehu I., Seghelini E. Neuromuscular sequelae of critical illness. Curr. Opin. Crit. Care. 2005; 11: 381–390.
  59. Leijten F.S., Harinck-de Weerd J.E., Poortvliet D.C., de Weerd A.W. The role of polyneuropathy in motor convalescence after prolonged mechanical ventilation. JAMA. 1995; 274: 1221–1225.
  60. Levine S., Nguyen T., Taylor N. et al. Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N. Engl. J. Med. 2008; 358: 1327–1335.
  61. Macintyre N.R., Cook D.J., Ely E.W. et al. Evidence-Based Guidelines for Weaning and Discontinuing Ventilatory Support. Chest 2001; 120: 375S–395S.
  62. Maramattom B.V., Wijdicks E.F. Acute neuromuscular weakness in the intensive care unit. Crit. Care Med. 2006; 34: 2835–2841.
  63. Martin U.J., Hincapie L., Nimchuk M. et al. Impact of whole-body rehabilitation in patients receiving chronic mechanical ventilation. Crit. Care Med. 2005; 33: 2259–2265.
  64. McGrogan A., Madle G.C., Seaman H.E., de Vries C.S. The epidemiology of Guillain-Barré syndrome worldwide. A systematic literature review. Neuroepidemiology. 2009; 32: 150–163.
  65. Mitch W.E., Goldberg A.L. Mechanisms of muscle wasting. The role of the ubiquitin-proteasome pathway. N. Engl. J. Med. 1996; 335:1897–1905.
  66. Nanas S., Kritikos K., Angelopoulos E. et al. Predisposing factors for critical illness polyneuromyopathy in a multidisciplinary intensive care unit. Acta Neurol. Scand. 2008; 118: 175–181.
  67. Nayci A., Atis S., Comelekoglu U. et al. Sepsis induces early phrenic nerve neuropathy in rats. Eur. Respir. J. 2005; 26: 686–692.
  68. Needham D.M. Mobilizing Patients in the Intensive Care Unit: Improving Neuromuscular Weakness and Physical Function. JAMA. 2008; 300: 1685–1690.
  69. Nierman D.M. A structure of care for the chronically critically ill. Crit. Care Clin. 2002; 18: 477–491.
  70. Novak K.R., Nardelli P., Cope T.C. et al. Inactivation of sodium channels underlies reversible neuropathy during critical illness in rats. J. Clin. Invest. 2009; 119: 1150–1158.
  71. Op De Coul A.A., Verheul G.A., Leyten A.C. et al. Critical illness polyneuromyopathy after artificial respiration. Clin. Neurol. Neurosurg. 1991; 93: 27–33.
  72. Polkey M.I., Moxham J. Clinical aspects of respiratory muscle dysfunction in the critically ill. Chest .2001; 119: 926–939.
  73. Ramsay D.A., Zochodne D.W., Robertson D.M. et al. A syndrome of acute severe muscle necrosis in intensive care unit patients. J. Neuropathol. Exp. Neurol. 1993; 52: 387–398.
  74. Reid C.L., Campbell I.T., Little R.A. Muscle wasting and energy balance in critical illness. Clin. Nutr. 2004; 23: 273–280.
  75. Rich M.M., Bird S.J., Raps E.C. et al. Direct muscle stimulation in acute quadriplegic myopathy. Muscle Nerve. 1997; 20: 665–673.
  76. Sander H.W., Golden M., Danon M.J. Quadriplegic areflexic ICU illness: selective thick filament loss and normal nerve histology. Muscle Nerve. 2002; 26: 499–505.
  77. Schwarz J., Planck J., Briegel J., Straube A. Single-fiber electromyography, nerve conduction studies, and conventional electromyography in patients with critical-illness polyneuropathy: evidence for a lesion of terminal motor axons. Muscle Nerve 1997; 20: 696–701.
  78. Schweickert W.D., Kress J.P. Strategies to optimize analgesia and sedation. Crit. Care. 2008; 12: S6.
  79. Schweickert W.D., Pohlman M.C., Pohlman A.S. et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009; 373: 1874–1882.
  80. Similowski T., Mehiri S., Duguet A. et al. Comparison of magnetic and electrical phrenic nerve stimulation in assessment of phrenic nerve conduction time. J. Appl. Physiol. 1997; 82: 1190–1199.
  81. Stevens R.D., Dowdy D.W., Michaels R.K. et al. Neuromuscular dysfunction acquired in critical illness: a systematic review. Intensive Care Med. 2007; 33: 1876–1891.
  82. Stibler H., Edström L., Ahlbeck K. et al. Electrophoretic determination of the myosin/actin ratio in the diagnosis of critical illness myopathy. Intensive Care Med. 2003; 29: 1515–1527.
  83. Svistunenko D.A., Davies N., Brealey D. et al. Mitochondrial dysfunction in patients with severe sepsis: an EPR interrogation of individual respiratory chain components. Biochim. Biophys. Acta. 2006; 1757:262–272.
  84. Tepper M., Rakic S., Haas J.A., Woittiez A.J. Incidence and onset of critical illness polyneuropathy in patients with septic shock. Neth. J.Med. 2000; 56: 211–214.
  85. Trojaborg W., Weimer L.H., Hays A.P. Electrophysiologic studies in critical illness associated weakness: myopathy or neuropathy–a reappraisal. Clin. Neurophysiol. 2001; 112: 1586–1593.
  86. Vassilakopoulos T. Ventilator-induced diaphragm dysfunction: the clinical relevance of animal models. Intensive Care Med. 2008; 34:7–16.
  87. Watling S.M., Dasta J.F. Prolonged paralysis in intensive care unit patients after the use of neuromuscular blocking agents: a review of the literature. Crit. Care Med. 1994; 22: 884–893.
  88. Weber-Carstens S., Koch S., Spuler S. et al. Nonexcitable muscle membrane predicts intensive care unit-acquired paresis in mechanically ventilated, sedated patients. Crit. Care Med. 2009; 37: 2632–2637.
  89. Williams A.B., Decourten-Myers G.M., Fischer J.E. et al. Sepsis stimulates release of myofilaments in skeletal muscle by a calcium-dependent mechanism. FASEB J. 1999; 13: 1435–1443.
  90. Williams S., Horrocks I.A., Ouvrier R.A. et al. Critical illness polyneuropathy and myopathy in pediatric intensive care: A review. Pediatric critical care medicine. 2007; 8: 18–22.
  91. Witt N.J., Zochodne D.W., Bolton C.F. et al. Peripheral nerve function in sepsis and multiple organ failure. Chest. 1991; 99: 176–184.
  92. Z’Graggen W.J., Lin C.S., Howard R.S. et al. Nerve excitability changes in critical illness polyneuropathy. Brain .2006; 129: 2461–2470.
  93. Zifko U.A., Zipko H.T., Bolton C.F. Clinical and electrophysiological findings in critical illness polyneuropathy. J. Neurol. Sci. 1998; 159:186–193.
  94. Zilberberg M.D., Luippold R.S., Sulsky S., Shorr A.F. Prolonged acute mechanical ventilation, hospital resource utilization, and mortality in the United States. Crit. Care Med. 2008; 36: 724–730.
  95. Zochodne D.W., Bolton C.F., Thompson R.T. et al. Myopathy in critical illness. Muscle Nerve. 1986; 9: 652.
  96. Zochodne D.W., Bolton C.F., Wells G.A. et al. Critical illness polyneuropathy. A complication of sepsis and multiple organ failure. Brain. 1987; 110: 819–841.

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