Acute neuromuscular weakness in the intensive care unit.

INTRODUCTION Patients in the intensive care unit develop generalized weakness due to a number of factors. Neuromuscular weakness is a common cause of failure to wean from the ventilator and decreased limb movements. A rational approach to evaluation of weakness will help to identify most of the common causes of neuromuscular weakness in the intensive care unit. AIMS This review provides an analysis of neuromuscular weakness and a practical algorithm to assist in diagnostic evaluation. CONCLUSIONS The most common acquired causes of weakness in the critically ill patient in the intensive care unit are critical illness polyneuropathy and critical illness myopathy. In the intensive care unit setting, electrophysiological studies, biopsies, and imaging studies are often necessary to complement the clinical impression.