Title

PO5.53 critical illness polyneuropathy and myopathy: experience at a tertiary care center in Pakistan

Document Type

Article

Department

Medicine; Neurology

Abstract

Background: Polyneuropathy and Myopathy are frequently encountere in the setting of Critical illness patients. Up to 50% of intensive care unit (ICU) patients show electrophysiological features of either or both conditions. These conditions interfere with functional recovery and delay weaning from mechanical ventilation, resulting in excess morbidity,mortality and cost of care. This study was to define the clinical spectrum of critical illness Polyneuropathy (CIP) and Myopathy (CIM) in a setting of developing country.
Methods: Hospital records spanning the period 2000 through 2005 weresearched with ICD-9 codes to identify patients with CIP and CIM. Functional improvement was judged by (i) increment of at least 1grade on the Medical Research Council scale of motor strength: and (ii)reappearance of deep-tendon reflexes.
Results: CIP or CIM was established in 47 patients of these, mean age was 54: mean length of stay in hospital 34 (range 8100) electrophysiological studiesrevealed CIP in 31 patients (66%) CIM in 12 (26%) and a mixedpicture in 4 (8%). Major co-morbid conditions included sepsis (39%) anddiabetes mellitus (17%), with an additional 28% having both and 17% having either. Neuromuscular blocking drugs were administered to 14 (30%) and steroids to 10 (21%) patients: an additional 11 (23%) patients received both agents while 12 (26%) patients received neither. In hospital mortality was 51%. At discharge and follow-up, motor improvement was seen in 11 (23%) while 12 (26%) remained neurologically unchanged.
Conclusions: We conclude that CIP and CIM are frequent identifiable complications of critical illness in our setting. These observations need further prospective studies to delineate risk factors and out come predictors, to improve critical care patients.

Publication

Clinical Neurophysiology