Critical-Illness-Polyneuropathy as sequelae of severe neurological illness: Incidence and impact on ventilator therapy and rehabilitation

Abstract

Introduction:

Critical-Illness-Polyneuropathy (CIP) is common in critically ill patients. In contrast to CIP arousing from primary non-neurological causes, studies dealing with CIP following a primary neurological illness are rare. This mono-center, retrospective study was performed to examine a) the incidence of CIP in patients after severe neurological illnesses and b) the impact on ventilator therapy.

Material and Methods:

Retrospective analysis of all patients, admitted for early (post-acute) neurological rehabilitation following severe neurological diseases between 01.01.2006 and 31.12.2010. Patients routinely underwent standard electrophysiological evaluation (nerve conduction studies of 8 motor and 6 sensory nerves; needle electromyography of 6 muscles). Diagnosis of CIP required a) pathological spontaneous activity in at least two muscles and b) reduced compound muscle activity potentials (CMAP) in at least two motor nerves of different extremities.

Results:

CIP was diagnosed in 430 of 623 patients (69.0%). Patients with proven CIP required significantly (p < 0.001) longer ventilator therapy (33.1 days) in contrast to patients without CIP (21.5 days).

Conclusion:

CIP is common in patients suffering from primary severe neurological diseases. Due to CIP, duration of ventilator therapy is significantly prolonged. In patients with severe neurological diseases electrophysiology is crucial to establish the correct diagnosis.