Neuromuscular complications of critical illness

There has recently been considerable growth in the literature describing these complications. The muscle may be weak as a result of atrophy, which can progress at an alarming rate in the catabolic critically ill patient. This atrophy may occasionally be complicated by a severe necrotizing myopathy. The neuromuscular junction may be blocked by the injudicious use of muscle relaxants, particularly when administered by infusion to patients with renal or hepatic failure. Finally, an acute axonal neuropathy (the critical illness neuropathy) may complicate severe illness, often when there is concomitant sepsis and multiple organ failure. The assessment and management of these is no different from any of the other causes of weakness. The long-term prognosis is usually good.

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