ICU-acquired weakness

Introduction

Epidemology:

• prevalent in critically ill patients

Pathology

• weakness can be secondary to polyneuropathy &/or myopathy

Clinical manifestations

• muscle weakness
  • proximal & distal symmetric flaccid weakness
  • weakness of respiratory muscles
  • sparing of cranial nerves
• reflexes are usually preserved
• failure to weaning from ventilation is often 1st sign
• can occur within a week of ICU presentation

* diagnosis of exclusion

Diagnostic procedures

• Medical Research Council muscle scale 1st step in evalutating ICU-acquired weakness
  • rarely used, requires patient participation
• electromyography & nerve conduction velocity is gold standard

Management

• aggressive management of critical illness
• early mobilization
• management of hyperglycemia

More general terms

• critical illness syndrome

Additional terms

• critical illness weakness; critical illness neuromyopathy