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Research Article| Volume 357, ISSUE 1-2, P276-281, October 15, 2015

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Critical illness polyneuropathy and myopathy in a rural area in Vietnam

Published:August 05, 2015DOI:https://doi.org/10.1016/j.jns.2015.08.005

      Highlights

      • The incidence of CIP/CIM in the ICU of a rural area in Vietnam is 55% (73/133).
      • Distribution of CIP, CIM and CIPNM is 48% (35), 22% (16) and 30% (22), respectively.
      • SIRS, shock condition and electrolyte disturbances are CIP/CIM independent risk factors.
      • CIP/CIM is associated with poorer outcomes on recovery, mortality rate and admission.

      Abstract

      Introduction

      Critical illness polyneuropathy, myopathy and polyneuromyopathy, grouped under the term CIP/CIM, share several risk factors and are associated with debilitating outcomes.

      Objective

      To assess the incidence and distribution of CIP/CIM subtypes and evaluate the risk factors and outcomes of CIP/CIM in a rural hospital in Vietnam.

      Method

      One hundred and thirty three critically ill patients treated more than ten days in the ICU were enrolled. The Medical Research Council (MRC) sum scores and the Overall Neuropathy Limitations Scale (ONLS) score were calculated and risk factors were monitored. Extensive electrodiagnostic investigations were performed to confirm the diagnosis of CIP/CIM.

      Results

      CIP/CIM was diagnosed in 73 (55%) patients. The distribution of polyneuropathy, myopathy and polyneuromyopathy was 35 (48%), 16 (22%) and 22 (30%), respectively. Independent risk factors included systemic inflammatory response syndrome, shock, and electrolyte disturbances. Compared to patients without CIP/CIM, patients with CIP/CIM experienced a mortality rate of 49% vs. 30%, a length of stay in ICU of 20.3 days vs. 14.3 days, an ONLS score at day thirty of 4.2 vs. 1.3 and at day ninety of 2.7 vs. 1.8.

      Conclusion

      The study revealed that the diagnosis of CIP/CIM was associated with significantly poorer outcomes in comparison to controls.

      Abbreviations:

      CIM (critical illness myopathy), CIP (critical illness polyneuropathy), CIPNM (critical illness polyneuromyopathy), CIP/CIM (critical illness polyneuropathy and/or myopathy), CMAPs (compound muscle action potentials), CSF (cerebrospinal fluid), EDX (electrodiagnostic), EMG (electromyography), ICU (intensive care unit), MOF (multiple organ failure), MUAPs (motor unit action potentials), NCS (nerve conduction studies), SIRS (systemic inflammatory response syndrome), SNAP (sensory nerve action potential), MRC (Medical Research Council), ONLS (Overall Neuropathy Limitations Scale)

      Keywords

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