What is critical illness polyneuropathy?
Critical illness polyneuropathy (CIP) develops in up to 50% of adult ICU patients who have lengthy mechanical ventilation, sepsis, or multiorgan failure. CIP may coexist with critical-illness myopathy in the same patient.
Attention typically is brought to the neuropathy by difficulty in weaning the patient from the ventilator as a result of respiratory muscle weakness.
Severe cases, with lengthy hospitalization, have limb weakness, sensory loss, and depressed stretch tendon reflexes.
Electrophysiologic testing and nerve and muscle biopsies show findings consistent with axonal polyneuropathy and help to distinguish CIP from GBS, disorders of neuromuscular transmission, and myopathy.
Most patients who survived their critical illness recover from CIP but recovery may be slow and often incomplete, even after 1 to 2 years.
