Polyneuropathy: potential cause of difficult weaning.

Severe critically ill polyneuropathy (CIP) is a neurologic syndrome with potential effects on ventilatory weaning. Fifteen CIP patients with the following clinical criteria were diagnosed: limb weakness, amyotrophy, and reduced deep tendon reflexes. Electromyogram (EMG) confirmed polyneuropathy by the following signs: denervation, normal nerve conduction velocities, normal distal latencies, and decreased compound action potential. It was observed that motor signs were more important than sensitivity. EMG performed during ICU hospitalization showed axonal abnormalities. Ventilation and mean duration of weaning were unusually long. Four patients had EMG a few years after discharge; the recovery was delayed and incomplete. The present study suggests that CIP is a multifactorial disease.