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Korean J Crit Care Med > Volume 20(1); 2005 > Article
Korean Journal of Critical Care Medicine 2005;20(1): 38-43.
원저 : 인공호흡기 치료 중 발생한 Critical Illness Polyneuropathy의 임상상
이성순, 진재용, 임채만, 고윤석
인제대학교 의과대학 일산백병원 내과학교실, *울산대학교 의과대학 서울아산병원 호흡기내과학교실
Clinical Findings of Critical Illness Polyneuropathy in Patients with Mechanical Ventilator Treatment
Sung Soon Lee, Jae Yong Chin, Chae Man Lim, Younsuck Koh
1Division of Pulmonary & Critical Care Medicine, University of Inje, Korea.
2Division of Pulmonary & Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. yskoh@amc.seoul.kr
ABSTRACT
BACKGROUND: Critical illness polyneuropathy (CIP) is a primary distal axonal degeneration of motor and sensory fibers leading to severe limb weakness and difficulty in weaning from ventilator in critically ill patients. The object of this study is to evaluate the clinical findings of CIP and the risk factors associated with CIP development in patients with mechanical ventilator treatment. METHODS: We examined 40 patients, between March 2002 to February 2003, who manifested muscular weakness and received mechanical ventilation (MV) more than three days, prospectively. Nerve conduction velocity (NCV) and electromyography (EMG) were performed in all patients in the ICU. We examined the use of drugs (neuromuscular blocking agents, corticosteroid, and aminoglycoside), duration of MV and weaning, and APACHE II score. RESULTS: We observed 40 patients who showed muscular weakness, 9 patients were diagnosed as CIP. NCV study demonstrated decreased action potential amplitude, predominantly in motor nerve, distal part. There was no significant difference in duration of MV and weaning, drug use, APACHE II score between the groups with CIP and without CIP. CONCLUSIONS: CIP is an important neuromuscular complication of the patients in ICU. We should consider the possibility of the development of CIP in patients who showed muscular weakness and difficult weaning in critically ill patients.
Key Words: Clinical characteristics; Complication; Critical illness polyneuropathy; Mechanical ventilation
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