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Polyneuropathies in critically ill patients: a prospective evaluation

K Berek1, J Margreiter, J Willeit

  • 1Universitätsklinik für Neurologie, Innsbruck, Austria.

Intensive Care Medicine
|September 1, 1996
PubMed
Summary

Sepsis and multiple organ failure frequently cause polyneuropathy in critically ill patients. Electrophysiologic testing is more effective than clinical exams for diagnosing this nerve condition.

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Area of Science:

  • Critical Care Medicine
  • Neurology
  • Intensive Care

Background:

  • Sepsis and systemic inflammatory response syndrome (SIRS) are common in intensive care units.
  • Multiple organ failure (MOF) is a severe complication associated with sepsis/SIRS.
  • Polyneuropathies can develop in critically ill patients, but their incidence and characteristics in sepsis/SIRS with MOF require further elucidation.

Purpose of the Study:

  • To investigate the incidence, severity, and clinical course of polyneuropathies in patients experiencing sepsis or SIRS with MOF.
  • To compare the diagnostic utility of clinical neurologic examination versus electrophysiologic methods in detecting polyneuropathies in this patient cohort.

Main Methods:

  • A prospective study was conducted involving 22 adult patients diagnosed with sepsis or SIRS and MOF.

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  • Patients underwent clinical neurologic examinations and electro myography/nerve conduction velocity (EMG/NCV) measurements during their ICU stay and at a 2-3 month follow-up.
  • Strict inclusion and exclusion criteria were applied to ensure a homogenous patient population.

    • Main Results:

    • Clinical examination identified polyneuropathy in 9 patients initially and 7 at follow-up.
    • Electrophysiologic investigations revealed polyneuropathy in 18 patients at the initial assessment and 11 patients at the 2-3 month follow-up.
    • The overall incidence of polyneuropathy detected by electrophysiology was high in this patient group.

    Conclusions:

    • A high incidence (81.8%) of polyneuropathy was observed in patients with sepsis or SIRS combined with MOF.
    • Electrophysiologic investigation demonstrated superior sensitivity compared to clinical neurologic examination for detecting polyneuropathies in this critically ill population.
    • Early and accurate diagnosis of polyneuropathy is crucial for managing critically ill patients with sepsis/SIRS and MOF.