Neurological disturbances in critically ill patients: why to diagnose them?

Management of critically ill patients brings about several ethical problems. One of them is to balance the extend of diagnostic procedures aimed at diagnosis of newly disclosed brain and neuromuscular disturbances as sequelae of critical illness to optimize care of these patients, and not to traumatize them and waste medical care sources. Both neuromuscular disturbances – critical illness polyneuropathy and myopathy, and critical illness encephalopathy worsen prognosis of critically ill patients. Effective treatment or prevention of these disturbance is, however, limited, and it is necessary to consider performance of invasive (muscle biopsy) or semi-invasive diagnostic procedures (electromyography) without clear impact on prognosis in routine management of these critically ill patients. The importance of early and exact diagnosis of these neurological disturbances will increase in the future provided effective treatment or prevention of these disturbances will be disclosed. Unsatisfactory treatment of critical illness including neurological disturbances leads to necessity of intensive research in this field, that is, however, to some extend complicated by more strict demands towards ethical attitude to all subjects participating in research.

Keywords: critical illness, critical illness polyneuropathy, critical illness myopathy, critical illness encephalophaty sepsis, multiple organ failure