الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 154 |  |  |
| | | from | 154 | | |
Abstract
Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) are overlapping syndromes of widespread muscle weakness and neurological dysfunction that can develop in critically ill patients receiving intensive care.
Acquired neuromuscular weakness due to critical illness polyneuropathy and myopathy (CIPNM) frequently develops in patients hospitalized in the intensive care unit for more one week.CIPNM may present with muscle weakness and failure to wean from mechanical ventilation, but is discovered more often and earlier by electrophysiological examination. Neuromuscular weakness is often encountered in patients in the intensive care unit (ICU).
Patients can be admitted to the ICU because of increasing muscle weakness and threating respiratory failure due to underlying neuromuscular disorder, mainly Guillian Barre Syndrome (GBS) and myasthenia gravis. Neuromuscular weakness can also be acquired: it frequently develops in the setting of critical illness in patients admitted to the ICU because of multi-trauma, severe infections, or (multiple) organ dysfunction. Neuromuscular weakness in critically ill patients may be caused by a polyneuropthy, myopathy or neuromuscular blockade.
All of the reported patients were admitted to the ICU and during a period of critical illness with sepsis and multi-organ failure requiring artificial respiration, the patients developed a severe sensory-motor polyneuropathy.
The polyneuropathy was axonal and could therefore be differentiated from demylinating form of GBS. Acute quadriplegic myopathy with selective myosin loss and acute necrotizing myopathy are considered to be a separate entity, as a part of critical illness myopathy. The basic pathophysiology for CIPNM is complex and involves metabolic, inflammatory and bioenergetics alterations.
The aim of the work was to highlight on critical illness polyneuropathy and myopathy in pediatric intensive care unit and its relation to difficult weaning from mechanical ventilation.
This cross-sectional study (prevalence survey) was conducted in the PICU of Pediatric Department and Rheumatology Department, Zagazig University Hospitals, with approval of institutional ethics committee.