II. Pathophysiology
- Neurogenic atrophy and axonal degeneration results in acute motor and sensory denervation
- Results in leg and respiratory Muscle Weakness
III. Risk Factors
- Prolonged ICU Admission
- Sepsis
- Multiorgan Failure
- Hyperglycemia
IV. Diagnosis
- Similar diagnostic criteria for Myopathy Following ICU Admission
- Limb Weakness AND
- Unexplained difficult mechanical Ventilator Weaning
V. Management
- Physical rehabilitation
- No current evidence to support for confirmed Polyneuropathy (and no Myopathy)
- Contrast with Myopathy Following ICU Admission in which physical therapyis effective
- Neuropathic pain management
- Capsaicin Cream
- Anticonvulsants such as Gabapentin (Neurontin) or Pregabalin (Lyrica)
- Selective Serotonin Reuptake Inhibitors (SSRI)
- Serotonin Norepinephrine Reuptake Inhibitors such as Venlafaxine (Effexor) or Duloxetine (Cymbalta)
VI. Course
- Nerve function improves as medical disorders improve, but weakness and numbness may persist
- Resolves in most cases within 3 years of ICU discharge
VII. Prevention
- Early mobilization in ICU improves mobility and strength