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Muscle weakness in critically ill children.

B L Banwell1, R J Mildner, A C Hassall

  • 1Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada. brenda.banwell@sickkids.ca

Neurology
|December 25, 2003
PubMed
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Muscle weakness affects 1.7% of critically ill children, often persisting long-term. Pediatric intensive care unit (ICU) survivors, particularly transplant recipients, face a significant risk of this condition.

Area of Science:

  • Pediatric Critical Care Medicine
  • Neuromuscular Disorders
  • Intensive Care Unit (ICU) Outcomes

Background:

  • Muscle weakness is a potential complication in critically ill pediatric patients.
  • Understanding the incidence and risk factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the frequency of generalized muscle weakness in children admitted to a pediatric intensive care unit (ICU).
  • To identify potential risk factors and long-term consequences of muscle weakness in this population.

Main Methods:

  • Prospective study involving 830 children (3 months to 17 years 11 months) admitted to a pediatric ICU for over 24 hours.
  • Neuromuscular examinations were conducted.
  • Data on clinical course, treatments, and outcomes were collected.

Related Experiment Videos

Main Results:

  • Generalized muscle weakness was identified in 1.7% (14 of 830) of patients.
  • Weakness was associated with failed extubation, multiple organ dysfunction, and sepsis.
  • Solid organ or bone marrow transplant recipients represented a significant proportion of affected children (8 of 14).
  • Muscle biopsy revealed acute quadriplegic myopathy in examined patients.
  • Persistent weakness was observed in survivors for 3 to 12 months post-ICU discharge.

Conclusions:

  • Muscle weakness is an infrequent yet significant complication of critical illness in children.
  • Pediatric ICU patients, especially transplant recipients, are at heightened risk.
  • Early identification and management strategies are warranted to mitigate long-term functional deficits.