Τίτλος:
Predisposing factors for critical illness polyneuromyopathy in a multidisciplinary intensive care unit
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Nanas, S.
Kritikos, K.
Angelopoulos, E.
Siafaka, A.
Tsikriki, S.
Poriazi, M.
Kanaloupiti, D.
Kontogeorgi, M.
Pratikaki, M.
Zervakis, D.
Routsi, C.
Roussos, C.
Περιοδικό:
Acta Neurologica Scandinavica
Λέξεις-κλειδιά:
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
DOI:
10.1111/j.1600-0404.2008.00996.x
