@article{2995879,
    title = "Predisposing factors for critical illness polyneuromyopathy in a multidisciplinary intensive care unit",
    author = "Nanas, S. and Kritikos, K. and Angelopoulos, E. and Siafaka, A. and Tsikriki, S. and Poriazi, M. and Kanaloupiti, D. and Kontogeorgi, M. and Pratikaki, M. and Zervakis, D. and Routsi, C. and Roussos, C.",
    journal = "Acta Neurologica Scandinavica",
    year = "2008",
    volume = "118",
    number = "3",
    pages = "175-181",
    issn = "0001-6314, 1600-0404",
    doi = "10.1111/j.1600-0404.2008.00996.x",
    keywords = "aminoglycoside antibiotic agent;  glucose, adult;  APACHE;  article;  controlled study;  critical illness;  disease predisposition;  disease severity;  female;  glucose blood level;  hospital admission;  hospital bed capacity;  human;  hyperglycemia;  intensive care unit;  major clinical study;  male;  multivariate logistic regression analysis;  neuromuscular system;  observational study;  polyneuropathy;  prospective study;  risk factor, Aminoglycosides;  Anti-Bacterial Agents;  APACHE;  Bacteremia;  Blood Glucose;  Female;  Gram-Negative Bacterial Infections;  Humans;  Hyperglycemia;  Intensive Care Units;  Male;  Middle Aged;  Polyneuropathies;  Risk Factors",
    abstract = "Objective - To investigate risk factors of critical illness polyneuromyopathy (CIPM) in a general multidisciplinary intensive care unit (ICU). Patients and methods - Prospective observational study in a 28-bed university multidisciplinary ICU. Four hundred and seventy-four (323 M/151 F, age 55 ± 19) consecutive patients were prospectively evaluated. All patients were assigned admission Acute Physiology and Chronic Health Evaluation (APACHE II; 15 ± 7) and Sequential Organ Failure Assessment (SOFA; 6 ± 3) scores and were subsequently evaluated for newly developed neuromuscular weakness. Other potential causes of new-onset weakness after ICU admission were excluded before CIPM was diagnosed. Results - Forty-four (23.8%) of 185 patients developed generalized weakness that met the criteria for CIPM. Patients with CIPM had higher APACHE II (18.9 ± 6.6 vs 15.6 ± 6.4, P = 0.004) and SOFA scores (8.4 ± 2.9 vs 7.1 ± 2.9, P = 0.013). According to multivariate logistic regression analysis, the following risk factors were independently associated with the development of CIPM: severity of illness at the time of ICU admission, administration of aminoglycoside antibiotics and high blood glucose levels. Analysis according to severity of illness stratification revealed the emergence of Gram (-) bacteremia as the most important independent predisposing factor for CIPM development in less severely ill patients. Conclusions - CIPM has a high incidence in the ICU setting. Our study revealed the association of aminoglycosides, hyperglycemia and illness severity with CIPM development, as well as the association between Gram (-) bacteremia and development of CIPM in less severely ill patient population. Copyright © 2008 The Authors."
}