ICU-AW and early rehab

Question 1

Define ICU acquired weakness (ICUAW)?

Answer 1

ICUAW is a syndrome of generalized limb weakness that develops while the patient is critically ill and for which there is no alternative explanation other than the critical illness itself.

Question 2

Define critical illness polyneuropathy (CIP)

Answer 2

Electrophysiological evidence of distal axonal degeneration (sensory loss (as well as motor loss))

Question 3

Define critical illness myopathy (CIM)

Answer 3

Electrophysiological and/or histological evidence of myopathy (no sensory loss) – when muscle is lost

Question 4

Define critical illness neuromyopathy (CINM).

Answer 4

Both CIM and CIP

Question 5

Describe the clinical features of ICUAW

Answer 5

Symmetrical flaccidity - weakness on both sides
Proximal muscle wasting - distal CIM
Distal muscle wasting - proximal (CIP)
Spares facial muscles/cranial nerves
If neuropathic, can get some sensory involvement
Weaning failure
Reduced deep tendon reflexes