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ABSTRACT 642

A PROSPECTIVE DESCRIPTIVE STUDY ON CRITICAL ILLNESS POLYNEUROPATHY AND MYOPATHY (CIPNM) IN CRITICALLY ILL CHILDREN - PAEDIATRIC CIPNM STUDY

James, E.J.G.1; Buckleraj, C.T.1; Thomas, M.2; Alexander, M.2

Pediatric Critical Care Medicine: May 2014 - Volume 15 - Issue 4_suppl - p 145
doi: 10.1097/01.pcc.0000449368.13635.33
Abstracts of the 7th World Congress on Pediatric Critical Care
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1Paediatric Intensive Care Unit, Christian Medical College, Vellore, India 2Neurology, Christian Medical College, Vellore, India

Background and aims: CIPNM is a distal axonal sensorimotor polyneuropathy, in which distal degeneration of both motor and sensory axons occur without inflammation. It can complicate and prolong the disease process by failure to wean from the ventilator.

Aims: To find the prevalence of CIPNM in the PICU study population

To analyse the risk factors associated with it.

Methods: Children who either had SIRS and/or mechanically ventilated for more than 5 days and/or who developed MODS were included. They underwent neurological examination and electrophysiological studies at first and second week after inclusion. Those who had acute or pre-existing neurological disorders were excluded\

IRB cleared. Children were monitored for the development of CIPNM by clinical assessment and electrophysiological studies which were done at the time of recruitment and one week later.

Results: Among the 30 children recruited, 16 (53.3%) developed CIPNM; 8 died and 6 discharged against medical advice in a terminally ill state (DAMA) after the first NCS. (Fig.1). Overall, the mortality in the CIPNM group was higher (10,67%) than the non-CIPNM group (7,47%).

Figure

Figure

Among the risk factors, PRISM score, ventilation duration, presence of SIRS and MODS, hypoalbuminemia, hyperglycemia, PICU stay and mortality were higher in patients who developed CIPNM without statistical significance.

Conclusions: Incidence of CIPNM in the study cohort among PICU children is 53.3%. CPK elevated in 50% of patients with CIPNM, indicating that they had concurrent myopathy. Use of prednisolone was associated with the development of CIPNM. Overall, the mortality in the CIPNM group was higher than the non-CIPNM group (P =0.06).

©2014The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies