De Jonghe Bernard, Lacherade Jean-Claude, Durand Marie-Christine, Sharshar Tarek
Réanimation Médico-chirurgicale, Centre Hospitalier de Poissy, 10 rue du Champ- Gaillard, 78300 Poissy, France.
Crit Care Clin. 2006 Oct;22(4):805-18; abstract xi. doi: 10.1016/j.ccc.2006.08.001.
Critical illness neuromyopathy (CINM) is the most common peripheral neuromuscular disorder encountered in the ICU. Bilateral diffuse weakness predominant in the proximal part of the limbs after improvement of the acute phase of the critical illness is highly suggestive of CINM. Although muscle and peripheral nerve are often involved in combination, muscle involvement alone is increasingly identified on electrophysiologic investigation, including direct muscle stimulation. Respiratory weakness results in delayed weaning and prolonged mechanical ventilation. Besides muscle immobilization and prolonged sepsis-induced multiorgan failure, which are risk factors for CINM, hyperglycemia and use of corticosteroids might have a deleterious effect on the neuromuscular system in critically ill patients.
危重病性神经肌肉病（CINM）是重症监护病房（ICU）中最常见的周围神经肌肉疾病。危重病急性期改善后，双侧弥漫性无力以肢体近端为主，高度提示CINM。虽然肌肉和周围神经常合并受累，但在电生理检查（包括直接肌肉刺激）中，越来越多地发现仅肌肉受累。呼吸肌无力导致脱机延迟和机械通气时间延长。除了肌肉制动和脓毒症诱导的多器官功能衰竭时间延长（这是CINM的危险因素）外，高血糖和使用皮质类固醇可能对危重病患者的神经肌肉系统产生有害影响。
