Kane Sandra L, Dasta Joseph F
School of Pharmacy, University of Pittsburgh, Pennsylvania 15261, USA.
Pharmacotherapy. 2002 Mar;22(3):373-9. doi: 10.1592/phco.22.5.373.33199.
It is often difficult to isolate the origin of acute weakness in the critically ill population because of multiple etiologies. Aminoglycosides, corticosteroids, and neuromuscular blockers frequently are implicated as the source of acute weakness. Recently, critical illness polyneuropathy (CIP), a syndrome of unknown etiology, was added to the differential diagnosis. The frequency of CIP is approximately 70% in patients with sepsis. Early studies of CIP, which were mostly retrospective, underestimated its frequency due to the complexity of the diagnosis and unfamiliarity with the syndrome. Prospective studies have explored the causality and clinical outcomes of CIP Clinical outcomes of patients with CIP include difficulty weaning from mechanical ventilation, increased length of stay, prolonged recovery, and an overall mortality rate of 26-71%. The association of CIP with sepsis, multiorgan failure, and drugs is still unclear.
由于存在多种病因,在危重症患者中往往难以确定急性肌无力的病因。氨基糖苷类药物、皮质类固醇和神经肌肉阻滞剂常被认为是急性肌无力的病因。最近,危重病性多发性神经病(CIP)这一病因不明的综合征也被列入鉴别诊断范围。脓毒症患者中CIP的发生率约为70%。早期对CIP的研究大多是回顾性的,由于诊断复杂且对该综合征不熟悉,低估了其发生率。前瞻性研究探讨了CIP的因果关系和临床结局。CIP患者的临床结局包括机械通气撤机困难、住院时间延长、恢复时间延长以及总死亡率为26%至71%。CIP与脓毒症、多器官功能衰竭和药物之间的关联仍不明确。