Critical illness myopathy and polyneuropathy in children admitted to the ICU

Objective The aim of the present study was to detect critical illness polyneuropathy and myopathy in children admitted to the ICU in relation to clinical findings and therapeutic regimen. Background Critical illness polyneuropathy and myopathy is a frequent complication of critical illness, acutely and primarily affecting the motor and sensory axons. This disorder can cause severe limb weakness and prolonged weaning. Patients and methods This study included 75 patients with different diseases admitted to the pediatric ICU at Menoufia University and was conducted for the period of 2 years. The patients were divided into five groups. All patients underwent nerve conduction, and electromyography was carried out on the seventh day of admission to ICU. Results The mean age of the patients was 4.5 ± 2.3 years. Twenty-four (24%) patients developed critical illness neuropathy and myopathy, among whom 21 (28%) patients developed axonal polyneuropathy, one (1.3%) had demyelinating polyneuropathy, and two (2.7%) cases were myopathic. In children with sepsis the prevalence of axonal polyneuropathy was five (33.3%) cases, one case had axonal polyneuropathy and one had myopathy. Among children with chest diseases, four cases of the ventilated ones had axonal polyneuropathy, six (40%) cases of the sepsis ventilated children developed axonal polyneuropathy, and one was myopathic. One child of the ventilated children due to chest disease had demyelinating polyneuropathy, whereas the other five cases had axonal polyneuropathy. Overall, 66.7% of the deaths were of those who developed axonal polyneuropathy, and 85.7, 47.6, and 90.5% of the deaths were of those who were hyperglycemic, ventilated, and acidotic, respectively. Conclusion The incidence of critical illness axonal polyneuropathy was 28%, 1.3% for demyelinating polyneuropathy, and 2.7% for critical illness myopathy.