Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients.

摘要: Objective: To determine risk factors and clinical consequences of critical illness polyneuropathy (CIP) evaluated by the impact on duration mechanical ventilation, length stay mortality. Design: Inception cohort study. Setting: Intensive care unit a tertiary hospital. Patients: Septic patients with multiple organ dysfunction syndrome requiring ventilation without previous history polyneuropathy. Interventions: Patients underwent two scheduled electrophysiologic studies (EPS): 10th 21st days after onset ventilation. Results: Eighty-two were enrolled, although nine them not analyzed. Forty-six 73 presented CIP first EPS 4 other subjects diagnosed second evaluation. The APACHE II scores similar admission day EPS. However, [32.3 (21.1) versus 18.5 (5.8); p=0.002], ICU hospital in discharged alive from as well in-hospital mortality greater (42/50, 84% 13/23, 56.5%; p=0.01). After multivariate analysis, independent hyperosmolality [odds ratio (OR) 4.8; 95% confidence intervals (95% CI) 1.05–24.38; p=0.046], parenteral nutrition (OR 5.11; CI 1.14–22.88; p=0.02), use neuromuscular blocking agents 16.32; 1.34–199; p=0.0008) neurologic failure (GCS below 10) 24.02; 3.68–156.7; p<0.001), while renal replacement therapy had lower for development 0.02; 0.05–0.15; p<0.001). By 7.11; 1.54–32.75; p<0.007), age over 60 years 9.07; 2.02–40.68; p<0.002) worst SOFA 2.18; 1.27–3.74; predictors Conclusions: is associated increased Hyperosmolality, nutrition, non-depolarizing blockers can favor development.