PROLONGED MUSCLE WEAKNESS IN INTENSIVE-CA RE PATIENTS WITH SPECIAL EMPHASIS ON THE SO-CALLED CRITICAL ILLNESS POLYNEUROMYOPATHY

Generalized muscle weakness in critically ill patients can result in p rolonged periods of artificial ventilation and longer stays in the int ensive care unit. Both neuropathic (critical illness polyneuropathy) a nd myopathic (critical illness myopathy) abnormalities seem to play an important role for this prolonged weakness. This article reviews its complex differential diagnosis with special emphasis on the current un derstanding of the neuromuscular syndromes. An efficient diagnostic pl an is necessary for the exclusion of other curable causes of prolonged muscle weakness even in the presence of polyneuromyopathic changes. P sychological support of the patient and prophylaxis of secondary compl ications of prolonged immobilization are crucial when specific therapy is not possible.