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[Polyneuropathies during prolonged stays in resuscitation].
1Service de Rééducation Fonctionnelle Neurologique, Hôpital Taster Girard.
Revue Neurologique
|January 1, 1987
Summary
Severe nutritional deficiencies, not drug toxicity, likely cause multiple neuropathies in ICU patients. Early electrophysiologic testing aids diagnosis, with parenteral nutrition potentially improving recovery.
Area of Science:
- Neurology
- Intensive Care Medicine
- Clinical Electrophysiology
Background:
- Prolonged intensive care unit (ICU) stays can lead to critical illness polyneuropathy.
- Identifying the precise cause of neuropathy in critically ill patients is challenging.
- Nutritional status is a key factor in peripheral nerve health.
Observation:
- Four patients developed extensive multiple neuropathies following prolonged ICU stays.
- Onset of neuropathy was likely between days 10-30, obscured by altered consciousness.
- Electrophysiological and ultrastructural studies indicated acute axonal lesions.
Findings:
- Severe protein and/or vitamin deficiencies were identified as likely causes.
- Exclusion of toxic, infectious, or drug-related etiologies was established.
- Factors like chronic hypoxia and diabetes may predispose to neuropathy.
Implications:
- Early electrophysiologic exploration is crucial for diagnosing this complication.
- Parenteral nutrition may be superior to enteral feeding for accelerating recovery.
- Addressing nutritional deficits is paramount for managing ICU-acquired neuropathies.