Long-term Outcome and Prognosis of Critical Illness Polyneuromyopathy

Overview

Objective:
To evaluate the long-term outcome and prognosis in critically ill patients with neuromuscular complications.Design: Prospective clinical study.Setting: ICU Department of Neurology and Dep. Anaesthesiology and ICU, University Hospital Brno-Bohunice.Material and Methods: Seventy-nine critically ill patients were enrolled and forty-eight completed a one month follow up.Selected clinical parameters were prospectively evaluated over a 28-day period. Electrophysiological studies were performedduring the first week and at the end of the follow up in order to detect signs of critical illness polyneuromyopathy(CIPM). Clinical features and outcomes were evaluated six months after the onset of a critical illness in eleven patients withCIPM.Results: Electrophysiological signs of CIPM were detected in twenty-seven patients (56.3 %). Clinical manifestation with theonset of profound flaccid paralysis occurred in seven cases (14.6 %), four of them with difficult weaning from mechanicalventilation. Sixteen patients with CIPM died during six months after the onset of a critical illness – mortality rate 59.3 %. Ofthe survivors 7 patients (63.6 %) were independent in their daily activities (Barthel Index 60 or more).Conclusion: Despite a severe initial motor deficit, recovery from CIPM may be in most cases partial or complete within6-month period, with no significant impairment of patient´s self-sufficiency and quality of life.

Key words:
critical illness – polyneuropathy – myopathy – multiple organ failure – systemic inflammatory responsesyndrome