Recovery and long term functional outcome in people with critical illness polyneuropathy and myopathy: a scoping review

Domenico Intiso; Antonello Marco Centra; Michelangelo Bartolo; Maria Teresa Gatta; Michele Gravina; Filomena Di Rienzo

doi:10.1186/s12883-022-02570-z

Recovery and long term functional outcome in people with critical illness polyneuropathy and myopathy: a scoping review

BMC Neurol. 2022 Feb 11;22(1):50. doi: 10.1186/s12883-022-02570-z.

Authors

Domenico Intiso¹, Antonello Marco Centra², Michelangelo Bartolo³, Maria Teresa Gatta², Michele Gravina², Filomena Di Rienzo²

Affiliations

¹ Unit of Neuro-Rehabilitation and Rehabilitation Medicine, IRCCS "Casa Sollievo della Sofferenza", Viale dei Cappuccini, 71013, San Giovanni Rotondo (FG), Italy. d.intiso@operapadrepio.it.
² Unit of Neuro-Rehabilitation and Rehabilitation Medicine, IRCCS "Casa Sollievo della Sofferenza", Viale dei Cappuccini, 71013, San Giovanni Rotondo (FG), Italy.
³ Department of Rehabilitation, Neurorehabilitation Unit, Habilita Care & Research, Zingonia (Bergamo), Italy.

Abstract

Background: Intensive care unit acquired weakness (ICUAW), embraces an array of disorders labeled "critical illness polyneuropathy" (CIP), "critical illness myopathy" (CIM) or "critical illness polyneuromyopathy" (CIPNM). Several studies have addressed the various characteristics of ICUAW, but the recovery is still unclear.

Objective: The present review investigated the recovery and the long-term functional outcome of subjects with ICUAW, whether the types of ICUAW have different outcomes and whether there is any supporting evidence.

Methods: Literature search was performed from MEDLINE/PubMed, CINAHL, EMBASE, PeDro, Web of Science and Scopus. Inclusion criteria were: i) sample size including five or more subjects; ii) subjects who suffered from ICUAW and/or CIP, CIM and CIP/CIM; iii) ICUAW ascertained by EMG. Follow-ups longer than one year were defined as long-term.

Results: Twenty-nine studies met the inclusion criteria. In total, 788 subjects with ICUAW were enrolled: 159 (20.1%) died and 588 (74.6%) were followed. Of all the included patients, 613 (77.7%) had CIP, 82 (10.4%) CIM and 56 (7.1%) CIP/CIM. Overall, 70.3% of the subjects with ICUAW fully recovered. Seven (24.1%) studies had a follow-up longer than 1 year (range 2-8) with 173 (21.9%) subjects enrolled globally and 108 followed. Of these subjects, 88.8% gained full recovery. Most of the studies did not use proper functional scales and only 4 and 3 studies employed the Barthel scale and the Functional Independence Measure (FIM) scale. Differentiation between the types of ICUAW was performed in 7 studies, but only 3 studies reported that subjects with CIM had a better prognosis and earlier recovery than subjects with CIP/CIM.

Conclusions: Subjects with ICUAW could achieve good recovery and could improve at follow-up. However, the quality of the published studies due to short follow-ups and the paucity of defined outcome measures require confirms.

Keywords: Critical illness polyneuropathy; Functional outcome; ICU acquired weakness; Rehabilitation.

Publication types

Review

MeSH terms

Critical Illness
Humans
Intensive Care Units
Muscular Diseases*
Polyneuropathies*