Epidemiology and Diagnosis of Polyneuropathy in Critical Illness

When sepsis and/or multiple organ dysfunction (MOD) complicate the course of a severe primary illness, a critical illness arises. The frequency of this syndrome has been increasing in the last years mostly because the prolonged survival of Intensive Care Units (ICU) patients due to the advent of modern methods of treatment. The incidence of the syndrome in most of ICU is between 20 and 50%. Bolton [1], in a recent review, hypothesized that infections (through sepsis) or trauma may determine the so called systemic inflammatory response syndrome (SIRS) that, in turn, determines the conditions that lead to nervous system involvement. A detailed description of mechanisms that give rise to SIRS is reported in the paper of Bolton [1]. The nervous system manifestations evolve according to a well-defined pattern [2]. Sepsis induces a septic encephalopathy that can be reverted if the sepsis is successfully treated. The subsequent difficulty in weaning the patient from the ventilator may be caused from neuropathy, myopathy, or both.