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- Title
Patterns of Critical Illness Weakness in the ICU of a Tertiary care Institution.
- Authors
Koshy, K.; Alexander, M.; John, G.; Joseph, M.; Sen, N.
- Abstract
Aims and Objectives: To study the incidence, characterize the various electrophysiological abnormalities, identify predictors and measure outcome in a cohort of critically ill patients. Materials and Methods: Patients admitted to the medical and surgical ICUs of the institution, satisfying the inclusion criteria (presence of Systemic Inflammatory response syndrome (SIRS) or on mechanical ventilation for > 7 days) were subjected to routine nerve conduction studies after consent was obtained. Various clinical and biochemical parameters were compared with nerve function parameters. Results: A total of 30 patients were included in the study. Based on the NCS parameters, 4 distinct groups were discernible (Group I - IV). 27/30 (90%) had abnormal conductions - 3(10%) patients had normal conductions (group I), 10(33.3%) patients had predominant features of an axonal motor sensory polyneuropathy (CIN - Group II), 4(13.3%) patients had features of a predominant motor syndrome (CIMS - Group III), with normal SNAPs and high CK, 13(48.1%) patients had a combination of both processes (CINM - Group IV). The total mortality rate was 43.3% of which 40% were from Group II, 50% - Group III and 53.8% - Group IV. Conclusions: This study had shown a high incidence of electrophysiological abnormalities (90%) and the proportion of patients with concomitant muscle involvement was 56%. The poor outcomes were mainly found in the pure motor (75%) and the CINM group (69.2%). Exposure to both steroids and neuromuscular blocking agents (NMBAs) were found in a higher proportion of patients in the CIMS group and in the CINM group the exposure was mainly to steroids.
- Subjects
CATASTROPHIC illness; ASTHENIA; INTENSIVE care units; ELECTROPHYSIOLOGY; NEURAL conduction; POLYNEUROPATHIES; STEROIDS; NEUROMUSCULAR blocking agents
- Publication
Annals of Indian Academy of Neurology, 2008, Vol 11, pS142
- ISSN
0972-2327
- Publication type
Article