Publication details
Polyneuromyopatie kritického stavu. II. Rizikové faktory
| Title in English | Critical illness polyneuromyopathy. II. Risk factors |
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| Authors | |
| Year of publication | 2003 |
| Type | Article in Periodical |
| Magazine / Source | Česká a slovenská neurologie a neurochirurgie |
| MU Faculty or unit | |
| Citation | |
| Field | Neurology, neurosurgery, neurosciences |
| Keywords | Polyneuromyopathy; critical illness; risk factors |
| Description | The potential risk factors of critical illness polyneuromyopathy (CIPM) were prospectively evaluated for a 28-day period in a group of 79 critically ill patients. Forty eight patients completed the follow-up. The development of CIPM at the end of the first month was observed in 27 patients (56.3%), and it was associated with the occurrence and duration of the systemic inflammatory response syndrome (SIRS) (p<0.001) and with the degree of multiple organ failure expressed as the summed 28-day SOFA score (a quantitative score for evaluation of the degree of dysfunction or failure of the respiratory, cardiovascular, central nervous, hepatic, renal, and haematological systems) (p<0.001). Analysis of the individual organ scores showed independent association between the development of CIPM and the summed 28-day respiratory and central nervous system SOFA scores. Neither the admission SOFA score (at day 0) nor the summed first week SOFA score were associated with the CIPM development, while the summed week SOFA scores during next three weeks were significantly higher in the CIPM group. These findings support the possibility of etiological linkage between the SIRS and the development of both critical illness polyneuropathy and myopathy. Early detection of CIPM in a subgroup of patients during the first week of critical illness and the increase in the association between the degree of multiple organ failure and the CIPM development support the hypothesis of the CIPM being a part of the multiple organ failure (a neuromuscular failure). We didnot find independent influence of other potential factors upon the development of the CIPM, namely that of cumulative dose of corticosteroids, non-depolarising muscle blocking agents and aminoglycosides, age, gender, hypoalbuminaemia, hyperglycaemia, and ion dysbalance. |
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