NEUROPHYSIOLOGICAL STUDY OF CRITICAL ILLNESS POLYNEUROPATHY AND MYOPATHY IN CHILDREN ADMITTED TO PEDIATRIC INTENSIVE CARE UNIT | ||
| Al-Azhar Journal of Pediatrics | ||
| Article 2, Volume 24, Issue 3, July 2021, Pages 2183-2198 PDF (222.85 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/azjp.2021.210112 | ||
| Abstract | ||
| Background: Critical illness polyneuropathy (CIP) and myopathy (CIM) are frequent complication of critical illness in adults and are associated with high morbidity and mortality. Little is known about CIP and CIM among critically ill children regarding incidence, risk factors and outcome. Objective: To detect critical illness polyneuropathy and myopathy in children admitted to pediatric intensive care unit (P.I.C.U) in relation to clinical, laboratory findings and neurophysiological studies. Patients and Methods: This cross sectional observational study was carried out at P.I.C.U of Bab-El shereya university hospital on 100 patients aged from 2months to 15 years during the period from July 2019 to December 2020, they were selected by simple random method. All patients were submitted to medical history taking, complete clinical examination, laboratory investigations and neurophysiological studies including nerve conduction studies (NCS), motor and sensory, and electromyography (EMG).NCS and EMG were done at the seventh day of admission and on discharge. Motor nerve studies included bilateral median and peroneal nerves. Sensory nerves included right median and sural nerves. EMG included right tibialis anterior and gluteus muscles. According to results of NCS and EMG patients were divided into 2 groups; I with abnormal neurophysiological studies and group II with normal neurophysiological studies. The clinical and laboratory profiles of the studied patients had been recorded. Results: 29patients (29%) developed CIP/CIM: axonal polyneuropathy (24%) demyelinating polyneuropathy (1%) and myopathy (4%). While remaining patients (71%) showed normal neurorophysiological studies. CIP/CIM was significantly associated with thrombocytopenia, elevated liver enzymes, prolonged prothrombin time, Acidosis, hypocalcemia, hypoalbuminemia, hyperglycemia compared to patients with normal studies. Mortality rate and duration of PICU stay were significantly higher among patients with CIP/CIM. Conclusion: critically ill children frequently develop CIP/CIM, mostly of axonal polyneuropathy, which prolong duration at PICU specially children on mechanical ventilation with subsequently more invasive procedures and resource utilization. Keywords: Critical illness polyneuropathy and myopathy, nerve conduction studies, electromyography. | ||
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