Early signs of critical illness polyneuropathy in ICU patients with systemic inflammatory response syndrome or sepsis

Objective: To evaluate with electromyography the incidence and the time of appearance of neuromuscular abnormality in patients with systemic inflammatory response syndrome (SIRS) and/or sepsis. Design: Follow-up study. Setting: Intensive care unit of Helsinki University Hospital, Finland. Patients: Nine mechanically ventilated patients with SIRS and/or sepsis. Interventions: Electromyography and conduction velocity measurements on the 2nd-5th day after admission to the intensive care unit. Measurements and results: In all nine patients electromyography revealed signs of neuromuscular abnormality. The means of compound muscle action potential amplitudes of the median and ulnar nerves were decreased. Fibrillation was observed in four patients out of nine. Conclusion: Because neuromuscular abnormalities seem to develop earlier than previously reported, electroneuromyography should be used more frequently as a diagnostic test.