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Rev Neurol ; 43(3): 155-67, 2006.
Artigo em Espanhol | MEDLINE | ID: mdl-16871481

RESUMO

AIMS: To describe the pathophysiology, diagnosis and clinical manifestations of the neurological complications that critically ill patients often develop in intensive care units, and to discuss their treatment and prognosis, in the light of the most significant contemporary literature. DEVELOPMENT: The most frequent complication suffered by critically ill patients is sepsis, with encephalopathy as the main manifestation, and this has a direct effect on their prognosis. Polyneuropathy of the critically ill patient is linked to sepsis, as the main precipitating factor, as well as to the presence of high levels of glucose, which plays an important role in deciding whether mechanical ventilation can be withdrawn or not. Myopathy of the critically ill patient is related to the use of fluorinated steroids and neuromuscular blockers, which are frequently administered to these patients. All these entities represent a significant diagnostic challenge for the physician and are accompanied by important sequelae that continue after the patient's discharge from hospital, as well as myopathies and neuropathies associated to the use of drugs that are commonly administered to critically ill patients. It is therefore necessary to be familiar with the pathophysiology of the damage and with the associated factors, if a suitable diagnostic approach is to be employed. CONCLUSIONS: The incidence of these pathologies and their complications makes them important conditions that require a swift, accurate diagnosis so that treatment can be established early on and a prognosis can also be determined.


Assuntos
Estado Terminal , Doenças Neuromusculares , Antagonistas Adrenérgicos/efeitos adversos , Antagonistas Adrenérgicos/uso terapêutico , Aminoglicosídeos/efeitos adversos , Aminoglicosídeos/uso terapêutico , Amiodarona/efeitos adversos , Amiodarona/uso terapêutico , Anestésicos Intravenosos/efeitos adversos , Anestésicos Intravenosos/uso terapêutico , Antiarrítmicos/efeitos adversos , Antiarrítmicos/uso terapêutico , Anti-Infecciosos/efeitos adversos , Anti-Infecciosos/uso terapêutico , Antiulcerosos/efeitos adversos , Antiulcerosos/uso terapêutico , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Ciclosporina/efeitos adversos , Ciclosporina/uso terapêutico , Diagnóstico Diferencial , Humanos , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Unidades de Terapia Intensiva , Labetalol/efeitos adversos , Labetalol/uso terapêutico , Metronidazol/efeitos adversos , Metronidazol/uso terapêutico , Doenças Neuromusculares/tratamento farmacológico , Doenças Neuromusculares/etiologia , Doenças Neuromusculares/patologia , Doenças Neuromusculares/fisiopatologia , Omeprazol/efeitos adversos , Omeprazol/uso terapêutico , Fenitoína/efeitos adversos , Fenitoína/uso terapêutico , Polineuropatias/etiologia , Polineuropatias/metabolismo , Prognóstico , Propofol/efeitos adversos , Propofol/uso terapêutico , Sepse/complicações , Sepse/metabolismo , Tacrolimo/efeitos adversos , Tacrolimo/uso terapêutico
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