Intensive care unit acquired weakness. Pathogenesis, treatment, rehabilitation and outcome;Erworbene muskelschwäche des kritisch kranken. Pathogenese, behandlung, rehabilitation, outcome

Nervenarzt

Volumn 85, Issue 2, 2014, Pages 195-204

  Ponfick, M ^a   Bosl K ^a   Ludemann Podubecka J ^a   Neumann, G ^a   Pohl, M ^b   Nowak, D A ^a   Gdynia, H J ^a  

^a Klinik Kipfenberg   (Germany)

^b Klinik Bavaria in Kreischa GmbH   (Germany)

Author keywords

Intensive care medicine; Intensive care unit acquired weakness; Neurological rehabilitation; Sepsis; Ventilation

Indexed keywords

HUMAN; INTENSIVE CARE UNIT; INTENSIVE CARE UNIT ACQUIRED WEAKNESS; PATHOGENESIS; REVIEW; TREATMENT OUTCOME; WEAKNESS;

BED REST; EARLY AMBULATION; EVIDENCE-BASED MEDICINE; HUMANS; INTENSIVE CARE; MUSCLE WEAKNESS; RESPIRATION, ARTIFICIAL;

EID: 84898023392     PISSN: 00282804     EISSN: 14330407     Source Type: Journal    
DOI: 10.1007/s00115-013-3958-6     Document Type: Review

References (130)

1. Ahlbeck K, Fredriksson K, Rooyackers O et al (2009) Signs of critical illness polyneuropathy and myopathy can be seen early in the ICU course. Acta Anaesthesiol Scand 53:717-723
2. Ali NA, O'Brien JM Jr, Hoffmann SP et al (2008) Acquired weakness, handgrip strength, and mortality in critically ill patients. Am J Respir Crit Care Med 178:261-268
3. Annane D, Bellissant E, Cavaillon JM (2005) Septic shock. Lancet 365:63-78
4. Barohn RJ, Jackson CE, Rogers SJ et al (1994) Prolonged paralysis due to nondepolarizing neuromuscular blocking agents and corticosteroids. Muscle Nerve 17:647-654 (Pubitemid 24157390)
5. Bednarik J, Lukas Z, Vondracek P (2003) Critical illness polyneuromyopathy: the electrophysiological components of a complex entity. Intensive Care Med 29:1505-1514 (Pubitemid 37153595)
6. Bercker S, Weber-Carstens S, Deja M et al (2005) Critical illness polyneuropathy and myopathy in patients with acute respiratory distress syndrome. Crit Care Med 33:711-715
7. Berek K, Margreiter J, Willeit J et al (1996) Polyneuropathies in critically ill patients: a prospective evaluation. Intensive Care Med 22:849-855 (Pubitemid 26340629)
8. Bierbrauer J, Koch S, Olbricht C et al (2012) Early type II fiber atrophy in intensive care unit patients with nonexcitable muscle membrane. Crit Care Med 40:647-650
9. Boczkowski J, Lisdero CL, Lanone S et al (2001) Peroxynitrite-mediated mitochondrial dysfunction. Biol Signals Recept 10:66-80 (Pubitemid 32171159)
10. Bolton CF (2008) The discovery of critical illness polyneuropathy. Eur J Anaesthesiol Suppl 42:66-67
11. Bolton CF (1987) Electrophysiologic studies of critically ill patients. Muscle Nerve 10:129-135
12. Bolton CF (2005) Neuromuscular manifestations of critical illness. Muscle Nerve 32:140-163
13. Bolton CF (1996) Sepsis and the systemic inflammatory response syndrome: neuromuscular manifestations. Crit Care Med 24:1408-1416
14. Bolton CF, Gilbert JJ, Hahn AF et al (1984) Polyneuropathy in critically ill patients. J Neurol Neurosurg Psychiatry 47:1223-1231 (Pubitemid 15204538)
15. Bolton CF, Laverty DA, Brown JD et al (1986) Critically ill polyneuropathy: electrophysiological studies and differentiation from Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry 49:563-573 (Pubitemid 16106923)
16. Bolton CF, Zifko U, Bird SJ (2000) Clinical neurophysiology in the intensive care unit. Suppl Clin Neurophysiol 53:29-37
17. Boveris A, Alvarez S, Navarro A (2002) The role of mitochondrial nitric oxide synthase in inflammation and septic shock. Free Radic Biol Med 33:1186-1193 (Pubitemid 35246586)
18. Brealey D, Brand M, Hargreaves I et al (2002) Association between mitochondrial dysfunction and severity and outcome of septic shock. Lancet 360:219-223 (Pubitemid 34804650)
19. Buck M, Chojkier M (1996) Muscle wasting and dedifferentiation induced by oxidative stress in a murine model of cachexia is prevented by inhibitors of nitric oxide synthesis and antioxidants. EMBO J 15:1753-1765 (Pubitemid 26119211)
20. Burtin C, Clerckx B, Robbeets C et al (2009) Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med 37:2499-2505
21. Callahan LA, Supinski GS (2009) Hyperglycemia and acquired weakness in critically ill patients: potential mechanisms. Crit Care 13:125
22. Callahan LA, Supinski GS (2009) Sepsis-induced myopathy. Crit Care Med 37:S354-S367
23. Cheung AM, Tansey CM, Tomlinson G et al (2006) Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med 174:538-544 (Pubitemid 44330546)
24. De Jonghe B, Lacherade JC, Sharshar T et al (2009) Intensive care unit-acquired weakness: risk factors and prevention. Crit Care Med 37:S309-S315
25. De Jonghe B, Sharshar T, Lefaucheur JP et al (2002) Paresis acquired in the intensive care unit: a prospective multicenter study. JAMA 288:2859-2867 (Pubitemid 35425072)
26. De Letter MA, Schmitz PI, Visser LH et al (2001) Risk factors for the development of polyneuropathy and myopathy in critically ill patients. Crit Care Med 29:2281-2286 (Pubitemid 34038159)
27. Dellinger RP, Levy MM, Carlet JM et al (2008) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 36:296-327
28. Druschky A, Herkert M, Radespiel-Tröger M et al (2001) Critical illness polyneuropathy: clinical findings and cell culture assay of neurotoxicity assessed by a prospective study. Intensive Care Med 27:686-693 (Pubitemid 32318330)
29. Du J, Wang X, Miereles C et al (2004) Activation of caspase-3 is an initial step triggering accelerated muscle proteolysis in catabolic conditions. J Clin Invest 113:115-123 (Pubitemid 38541638)
30. Erbsloh F (1955) Polyneuritic pathological conditions in internal medicine. Munch Med Wochenschr 97:753-756
31. Faust SN, Heyderman RS, Levin M (2001) Coagulation in severe sepsis: a central role for thrombomodulin and activated protein C. Crit Care Med 29(7 Suppl):S62-S67
32. Faust SN, Levin M, Harrison OB et al (2001) Dysfunction of endothelial protein C activation in severe meningococcal sepsis. N Engl J Med 345:408-416 (Pubitemid 32747604)
33. Fletcher SN, Kennedy DD, Ghosh IR et al (2003) Persistent neuromuscular and neurophysiologic abnormalities in long-term survivors of prolonged critical illness. Crit Care Med 31:1012-1016 (Pubitemid 36444406)
34. Friedrich O (2008) Critical illness myopathy: sepsis-mediated failure of the peripheral nervous system. Eur J Anaesthesiol Suppl 42:73-82
35. Friedrich O, Fink RH, Hund E (2005) Understanding critical illness myopathy: approaching the pathomechanism. J Nutr 135:S1813-S1817
36. Friedrich O, Hund E, Weber C et al (2004) Critical illness myopathy serum fractions affect membrane excitability and intracellular calcium release in mammalian skeletal muscle. J Neurol 251:53-65 (Pubitemid 38210490)
37. Futier E, Constantin JM, Combaret L et al (2008) Pressure support ventilation attenuates ventilator-induced protein modifications in the diaphragm. Crit Care 12:R116
38. Garnacho-Montero J, Madrazo-Osuna J, García-Garmendia JL et al (2001) Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients. Intensive Care Med 27:1288-1296 (Pubitemid 32758926)
39. Gayan-Ramirez G, Testelmans D, Maes K et al (2005) Intermittent spontaneous breathing protects the rat diaphragm from mechanical ventilation effects. Crit Care Med 33:2804-2809 (Pubitemid 41816415)
40. Gerovasili V, Stefanidis K, Vitzilaios K et al (2009) Electrical muscle stimulation preserves the muscle mass of critically ill patients: a randomized study. Crit Care 13:R161
41. Giostra E, Magistris MR, Pizzolato G et al (1994) Neuromuscular disorder in intensive care unit patients treated with pancuronium bromide. Occurrence in a cluster group of seven patients and two sporadic cases, with electrophysiologic and histologic examination. Chest 106:210-220 (Pubitemid 24214754)
42. Glauser MP, Zanetti G, Baumgartner JD et al (1991) Septic shock: pathogenesis. Lancet 338:732-736
43. Gooch JL, Suchyta MR, Balbierz JM et al (1991) Prolonged paralysis after treatment with neuromuscular junction blocking agents. Crit Care Med 19:1125-1131
44. Goodman BP, Harper CM, Boon AJ (2009) Prolonged compound muscle action potential duration in critical illness myopathy. Muscle Nerve 40:1040-1042
45. Graffagnino C, Gurram AR, Kolls B et al (2010) Intensive insulin therapy in the neurocritical care setting is associated with poor clinical outcomes. Neurocrit Care 13:307-312
46. Green DM (2005) Weakness in the ICU: Guillain-Barre syndrome, myasthenia gravis, and critical illness polyneuropathy/myopathy. Neurologist 11:338-347
47. Green DM, O'phelan KH, Bassin SL et al (2010) Intensive versus conventional insulin therapy in critically ill neurologic patients. Neurocrit Care 13:299-306
48. Griffiths RD, Hall JB (2010) Intensive care unit-acquired weakness. Crit Care Med 38:779-787
49. Helliwell TR, Wilkinson A, Griffiths RD et al (1998) Muscle fibre atrophy in critically ill patients is associated with the loss of myosin filaments and the presence of lysosomal enzymes and ubiquitin. Neuropathol Appl Neurobiol 24:507-517 (Pubitemid 29002282)
50. Hermans G, De Jonghe B, Bruyninckx F et al (2008) Clinical review: critical illness polyneuropathy and myopathy. Crit Care 12:238
51. Hermans G, De Jonghe B, Bruyninckx F et al (2009) Interventions for preventing critical illness polyneuropathy and critical illness myopathy. Cochrane Database Syst Rev CD006832
52. Hermans G, Vanhorebeek I, Derde S et al (2009) Metabolic aspects of critical illness polyneuromyopathy. Crit Care Med 37:S391-S397
53. Herridge MS, Cheung AM, Tansey CM et al (2003) One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 348:683-693 (Pubitemid 36237037)
54. Heyland DK, Dhaliwal R, Day AG et al (2006) REducing Deaths due to OXidative Stress (The REDOXS Study): rationale and study design for a randomized trial of glutamine and antioxidant supplementation in critically-ill patients. Proc Nutr Soc 65:250-263 (Pubitemid 46323840)
55. Hussain SN, Mofarrahi M, Sigala I et al (2010) Mechanical ventilation-induced diaphragm disuse in humans triggers autophagy. Am J Respir Crit Care Med 182:1377-1386
56. Judemann K, Lunz D, Zausig YA et al (2011) Intensive care unit-acquired weakness in the critically ill: critical illness polyneuropathy and critical illness myopathy. Anaesthesist 60:887-901
57. Jung B, Constantin JM, Rossel N et al (2010) Adaptive support ventilation prevents ventilator-induced diaphragmatic dysfunction in piglet: an in vivo and in vitro study. Anesthesiology 112:1435-1443
58. Kerbaul F, Brousse M, Collart F et al (2004) Combination of histopathological and electromyographic patterns can help to evaluate functional outcome of critical ill patients with neuromuscular weakness syndromes. Crit Care 8:R358-R366
59. Khan J, Burnham EL, Moss M (2006) Acquired weakness in the ICU: critical illness myopathy and polyneuropathy. Minerva Anestesiol 72:401-406
60. Khan J, Harrison TB, Rich MM et al (2006) Early development of critical illness myopathy and neuropathy in patients with severe sepsis. Neurology 67:1421-1425 (Pubitemid 44632066)
61. Kho ME, Truong AD, Brower RG et al (2012) Neuromuscular electrical stimulation for intensive care unit-acquired weakness: protocol and methodological implications for a randomized, sham-controlled, phase II trial. Phys Ther 92:1564-1579
62. Koch S, Spuler S, Deja M et al (2011) Critical illness myopathy is frequent: accompanying neuropathy protracts ICU discharge. J Neurol Neurosurg Psychiatry 82:287-293
63. Lacomis D, Petrella JT, Giuliani MJ (1998) Causes of neuromuscular weakness in the intensive care unit: a study of ninety-two patients. Muscle Nerve 21:610-617 (Pubitemid 28185889)
64. Lacomis D, Smith TW, Chad DA (1993) Acute myopathy and neuropathy in status asthmaticus: case report and literature review. Muscle Nerve 16:84-90 (Pubitemid 23014308)
65. Lacomis D, Zochodne DW, Bird SJ (2000) Critical illness myopathy. Muscle Nerve 23:1785-1788
66. Latronico N (2003) Neuromuscular alterations in the critically ill patient: critical illness myopathy, critical illness neuropathy, or both Intensive Care Med 29:1411-1413
67. Latronico N, Bolton CF (2011) Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis. Lancet Neurol 10:931-941
68. Latronico N, Candiani A (1999) Neuromuscular disorders acquired in the ICU. Intensive Care Med 25:641-642
69. Latronico N, Fenzi F, Recupero D et al (1996) Critical illness myopathy and neuropathy. Lancet 347:1579-1582 (Pubitemid 26170874)
70. Latronico N, Peli E, Botteri M (2005) Critical illness myopathy and neuropathy. Curr Opin Crit Care 11:126-132 (Pubitemid 40488611)
71. Latronico N, Shehu I, Guarneri B (2009) Use of electrophysiologic testing. Crit Care Med 37:S316-S320
72. Lefaucheur JP, Nordine T, Rodriguez P et al (2006) Origin of ICU acquired paresis determined by direct muscle stimulation. J Neurol Neurosurg Psychiatry 77:500-506
73. Leijten FS, De Weerd AW, Poortvliet DC et al (1996) Critical illness polyneuropathy in multiple organ dysfunction syndrome and weaning from the ventilator. Intensive Care Med 22:856-861 (Pubitemid 26340630)
74. Levine S, Nguyen T, Taylor N et al (2008) Rapid disuse atrophy of diaphragm fibers in mechanically ventilated humans. N Engl J Med 358:1327-1335 (Pubitemid 351468409)
75. Lowry SF (1994) Sepsis and its complications: clinical definitions and therapeutic prospects. Crit Care Med 22:S1-S2
76. Maramattom BV, Wijdicks EF (2006) Acute neuromuscular weakness in the intensive care unit. Crit Care Med 34:2835-2841 (Pubitemid 44610951)
77. Mertens HG (1961) Disseminated neuropathy following coma. On the differentation of so-called toxic polyneuropathy. Nervenarzt 32:71-79
78. Mikaeili H, Yazdchi M, Barazandeh F et al (2012) Euglycemic state reduces the incidence of critical illness polyneuropathy and duration of ventilator dependency in medical intensive care unit. Bratisl Lek Listy 113:616-619
79. Morris C, Trinder JT (2002) Electrophysiology adds little to clinical signs in critical illness polyneuropathy and myopathy. Crit Care Med 30:2612 (Pubitemid 35351900)
80. Needham DM, Truong AD, Fan E (2009) Technology to enhance physical rehabilitation of critically ill patients. Crit Care Med 37:S436-S441
81. Nordon-Craft A, Schenkman M, Ridgeway K et al (2012) Physical therapy management and patient outcomes following ICU-acquired weakness: a case series. J Neurol Phys Ther 35:133-140
82. Novak P, Vidmar G, Kuret Z et al (2011) Rehabilitation of critical illness polyneuropathy and myopathy patients: an observational study. Int J Rehabil Res 34:336-342
83. Oehmichen F, Ketter G, Mertl-Rötzer M et al (2012) Weaning from prolonged mechanical ventilation in neurological weaning units: an evaluation of the German Working Group for early Neurorehabilitation. Nervenarzt 83:1300-1307
84. Oehmichen F, Pohl M, Schlosser R et al (2012) Critical illness polyneuropathy und polymyopathy. How certain is the clinical diagnosis in patients with weaning failure? Nervenarzt 83:220-225
85. Osler W (1892) The principles and practice of medicine. D Appleton, New York
86. Pattanshetty RB, Gaude GS (2011) Critical illness myopathy and polyneuropathy - a challenge for physiotherapists in the intensive care units. Indian J Crit Care Med 15:78-81
87. Perme C, Chandrashekar R (2009) Early mobility and walking program for patients in intensive care units: creating a standard of care. Am J Crit Care 18:212-221
88. Ponfick M, Wiederer R, Bösl K et al (2014) The influence of weaning duration on rehabilitative outcome in early neurological rehabilitation. Neurorehabilitation (in press)
89. Powers SK, Decramer M, Gayan-Ramirez G et al (2008) Pressure support ventilation attenuates ventilator-induced protein modifications in the diaphragm. Crit Care 12:191
90. Powers SK, Kavazis AN, Mcclung JM (2007) Oxidative stress and disuse muscle atrophy. J Appl Physiol 102:2389-2397 (Pubitemid 47080773)
91. Raghig H, Young GB, Hammond R et al (2010) A comparison of EMG and muscle biopsy in ICU weakness. Neurocrit Care 13:326-330
92. Rich MM, Raps EC, Bird SJ (1995) Distinction between acute myopathy syndrome and critical illness polyneuropathy. Mayo Clin Proc 70:198-200
93. Rich MM, Teener JW, Raps EC et al (1996) Muscle is electrically inexcitable in acute quadriplegic myopathy. Neurology 46:731-736 (Pubitemid 26099640)
94. Riedemann NC, Guo RF, Ward PA (2003) The enigma of sepsis. J Clin Invest 112:460-467 (Pubitemid 38056327)
95. Riedemann NC, Guo RF, Ward PA (2003) Novel strategies for the treatment of sepsis. Nat Med 9:517-524 (Pubitemid 36597096)
96. Routsi C, Gerovasili V, Vasileiadis I et al (2010) Electrical muscle stimulation prevents critical illness polyneuromyopathy: a randomized parallel intervention trial. Crit Care 14:R74
97. Sander HW, Golden M, Danon MJ (2002) Quadriplegic areflexic ICU illness: selective thick filament loss and normal nerve histology. Muscle Nerve 26:499-505
98. Sassoon C, Zhu E, Caiozzo V (2004) Assist-control mechanical ventilation attenuates ventilator-induced diaphragmatic dysfunction. Am J Respir Crit Care Med 170:626-632 (Pubitemid 39202204)
99. Satran R, Almog Y (2003) The coagulopathy of sepsis: pathophysiology and management. Isr Med Assoc J 5:516-520 (Pubitemid 36992235)
100. Schwarz J, Planck J, Briegel J et al (1997) Single-fiber electromyography, nerve conduction studies, and conventional electromyography in patients with critical-illness polyneuropathy: evidence for a lesion of terminal motor axons. Muscle Nerve 20:696-701 (Pubitemid 27197722)
101. Schweickert WD, Pohlman MC, Pohlman AS et al (2009) Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet 373:1874-1882
102. Seiser A, Schwarz S, Brainin M (1992) Critical illness polyneuropathy: clinical aspects and long-term outcome. Wien Klin Wochenschr 104:294-300
103. Semmler A, Okulla T, Kaiser M et al (2013) Long-term neuromuscular sequelae of critical illness. J Neurol 260:151-157
104. Shanely RA, Zergeroglu MA, Lennon SL et al (2002) Mechanical ventilation-induced diaphragmatic atrophy is associated with oxidative injury and increased proteolytic activity. Am J Respir Crit Care Med 166:1369-1374 (Pubitemid 35292704)
105. Showalter CJ, Engel AG (1997) Acute quadriplegic myopathy: analysis of myosin isoforms and evidence for calpain-mediated proteolysis. Muscle Nerve 20:316-322 (Pubitemid 27108150)
106. Sitwell LD, Weinshenker BG, Monpetit V et al (1991) Complete ophthalmoplegia as a complication of acute corticosteroid- and pancuronium-associated myopathy. Neurology 41:921-922
107. Spitzer AR, Giancarlo T, Maher L et al (1992) Neuromuscular causes of prolonged ventilator dependency. Muscle Nerve 15:682-686
108. Supplement (2009) ICU-acquired weakness: proceedings of a round table conference in Brussels, Belgium, March 2009 10. Crit Care Med 37:S295-S461
109. Takala J, Ruokonen E, Webster NR et al (1999) Increased mortality associated with growth hormone treatment in critically ill adults. N Engl J Med 341:785-792 (Pubitemid 29420473)
110. Tennilä A, Salmi T, Pettilä V et al (2000) Early signs of critical illness polyneuropathy in ICU patients with systemic inflammatory response syndrome or sepsis. Intensive Care Med 26:1360-1363
111. Tran DD, Groeneveld AB, Van Der Meulen J et al (1990) Age, chronic disease, sepsis, organ system failure, and mortality in a medical intensive care unit. Crit Care Med 18:474-479 (Pubitemid 20164866)
112. Trojaborg W, Weimer LH, Hays AP (2001) Electrophysiologic studies in critical illness associated weakness: myopathy or neuropathy - a reappraisal. Clin Neurophysiol 112:1586-1593 (Pubitemid 32763240)
113. Van Den Berghe G, Schoonheydt K, Becx P et al (2005) Insulin therapy protects the central and peripheral nervous system of intensive care patients. Neurology 64:1348-1353 (Pubitemid 40570499)
114. Van Den Berghe G, Wouters P, Weekers F et al (2001) Intensive insulin therapy in critically ill patients. N Engl J Med 345:1359-1367
115. Van Der Lely AJ, Veelo DP, Dongelmans DA et al (2006) Time to wean after tracheotomy differs among subgroups of critically ill patients: retrospective analysis in a mixed medical/surgical intensive care unit. Respir Care 51:1408-1415
116. Van Der Schaaf M, Beelen A, De Groot IJ (2000) Critical illness polyneuropathy: a summary of the literature on rehabilitation outcome. Disabil Rehabil 22:808-810 (Pubitemid 32040841)
117. Van Der Schaaf M, Beelen A, De Vos R (2004) Functional outcome in patients with critical illness polyneuropathy. Disabil Rehabil 26:1189-1197 (Pubitemid 39335150)
118. Van Der Schaaf M, Beelen A, Dongelmans D et al (2009) Poor functional recovery after a critical illness: a longitudinal study. J Rehabil Med 41:1041-1048
119. Van Hees HW, Schellekens WJ, Linkels M et al (2011) Plasma from septic shock patients induces loss of muscle protein. Crit Care 15:R233
120. Vassilakopoulos T, Petrof BJ (2004) Ventilator-induced diaphragmatic dysfunction. Am J Respir Crit Care Med 169:336-341 (Pubitemid 38134811)
121. Wijdicks EF, Fulgham JR (1994) Failure of high dose intravenous immunoglobulins to alter the clinical course of critical illness polyneuropathy. Muscle Nerve 17:1494-1495 (Pubitemid 24362833)
122. Wijdicks EF, Litchy WJ, Harrison BA et al (1994) The clinical spectrum of critical illness polyneuropathy. Mayo Clin Proc 69:955-959 (Pubitemid 24310074)
123. Wiles CM (1996) Neurological complications of severe illness and prolonged mechanical ventilation. Thorax 51:S40-S44
124. Witt NJ, Zochodne DW, Bolton CF et al (1991) Peripheral nerve function in sepsis and multiple organ failure. Chest 99:176-184
125. Zanotti E, Felicetti G, Maini M et al (2003) Peripheral muscle strength training in bed-bound patients with COPD receiving mechanical ventilation: effect of electrical stimulation. Chest 124:292-296 (Pubitemid 36851365)
126. Zifko UA (2000) Long-term outcome of critical illness polyneuropathy. Muscle Nerve 9:S49-S52
127. Zifko UA, Zipko HT, Bolton CF (1998) Clinical and electrophysiological findings in critical illness polyneuropathy. J Neurol Sci 159:186-193 (Pubitemid 28384528)
128. Zink W, Kollmar R, Schwab S (2009) Critical illness polyneuropathy and myopathy in the intensive care unit. Nat Rev Neurol 5:372-379
129. Zochodne DW, Bolton CF, Wells GA et al (1987) Critical illness polyneuropathy. A complication of sepsis and multiple organ failure. Brain 110:819-841
130. Zochodne DW, Ramsay DA, Saly V et al (1994) Acute necrotizing myopathy of intensive care: electrophysiological studies. Muscle Nerve 17:285-292 (Pubitemid 24080207)