Shepherd Starane, Batra Ayush, Lerner David P
Department of Neurology, Brigham and Women's Hospital & Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Neurohospitalist. 2017 Jan;7(1):41-48. doi: 10.1177/1941874416663279. Epub 2016 Aug 23.
Critical illness myopathy (CIM) and neuropathy are underdiagnosed conditions within the intensive care setting and contribute to prolonged mechanical ventilation and ventilator wean failure and ultimately lead to significant morbidity and mortality. These conditions are often further subdivided into CIM, critical illness polyneuropathy (CIP), or the combination-critical illness polyneuromyopathy (CIPNM). In this review, we discuss the epidemiology and pathophysiology of CIM, CIP, and CIPNM, along with diagnostic considerations such as detailed clinical examination, electrophysiological studies, and histopathological review of muscle biopsy specimens. We also review current available treatments and prognosis. Increased awareness and early recognition of CIM, CIP, and CIPNM in the intensive care unit setting may lead to earlier treatments and rehabilitation, improving patient outcomes.
危重病性肌病（CIM）和神经病在重症监护环境中诊断不足，会导致机械通气时间延长和脱机失败，并最终导致显著的发病率和死亡率。这些病症通常进一步细分为CIM、危重病性多发性神经病（CIP）或两者合并的危重病性多神经肌病（CIPNM）。在本综述中，我们讨论了CIM、CIP和CIPNM的流行病学和病理生理学，以及诊断方面的考虑因素，如详细的临床检查、电生理研究和肌肉活检标本的组织病理学检查。我们还综述了当前可用的治疗方法和预后情况。在重症监护病房环境中提高对CIM、CIP和CIPNM的认识并早期识别，可能会带来更早的治疗和康复，改善患者预后。
