Critical Care Sister, Lancashire Teaching Trust, Preston, United Kingdom.
Intensive Crit Care Nurs. 2010 Dec;26(6):353-62. doi: 10.1016/j.iccn.2010.08.008.
Following critical illness requiring prolonged mechanical ventilation and sedation, intensive care patients often present with neuromuscular weakness. This results from critical illness polyneuropathy (CIP) and critical illness myopathy (CIM). A lack of diagnostic criteria for each syndrome complicates prevention and treatment. Consequently the term critical illness polyneuromyopathy (CIPNM) has emerged and is characterised by severe weakness, reduced or absent limb reflexes and marked muscle wasting. Although clinical trials report a high incidence of CIPNM, in clinical practice it often remains undetected. The pathophysiological mechanisms that lead to neuromuscular weakness are not entirely clear, however several risk factors have been identified and will be discussed. To date, there are no specific treatments or interventions available to reduce the onset or impact of CIPNM. This paper will review the strategies employed that are supportive and aimed at controlling the associated risk factors.
在需要长时间机械通气和镇静的危重病后，重症监护患者常出现神经肌肉无力。这是由危重病性多发性神经病（CIP）和危重病性肌病（CIM）引起的。由于每个综合征缺乏诊断标准，因此预防和治疗变得复杂。因此，出现了危重病性多神经病肌病（CIPNM）这一术语，其特征为严重无力、肢体反射减弱或消失以及明显的肌肉萎缩。尽管临床试验报告 CIPNM 的发病率很高，但在临床实践中，它常常未被发现。导致神经肌肉无力的病理生理机制尚不完全清楚，但已经确定了一些危险因素，并将进行讨论。迄今为止，尚无特定的治疗方法或干预措施可用于减少 CIPNM 的发生或影响。本文将回顾支持和旨在控制相关危险因素的策略。
