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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Article info
Publication history
Published online: August 05, 2015
Accepted:
August 4,
2015
Received in revised form:
July 16,
2015
Received:
April 28,
2015
Identification
Copyright
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
