Polyneuropathy in Critically Ill Mechanically Ventilated Children : Experience From a Tertiary Care Hospital in North India
OBJECTIVES: To determine the prevalence of critical illness polyneuropathy and its risk factors in critically ill children mechanically ventilated for 7 days or more.
DESIGN: Observational cohort study.
SETTING: PICU of a tertiary care hospital from North India.
PATIENTS: Children 1-15 years old admitted in PICU from June 2016 to September 2017, mechanically ventilated for 7 days or more, excluding those with diagnosed neuromuscular disease, stroke, or spinal pathology.
INTERVENTION: Demographic details, diagnosis, treatment details, and anthropometry at admission and enrolment were recorded. Nerve conduction studies were performed after enrolment and repeated a week later, if the child was still in PICU. Medical Research Council scoring for muscle strength was performed in survivors. Risk factors including Pediatric Index of Mortality-2 score, sepsis, multiple organ dysfunction, hypoalbuminemia, use of steroids, neuromuscular-blocking agents, and vasopressors were recorded. Samples for the level of micronutrients (copper, zinc, folate, and vitamin B12) were collected at the time of enrolling the child and at the time of discharge.
MEASUREMENTS AND MAIN RESULTS: Thirty-two children were enrolled, of whom 29 had features of critical illness polyneuropathy on evaluation at day 8 of mechanical ventilation (prevalence, 90.6% [95% CI, 80.5-100%]). The polyneuropathy was axonal in 26 (81.2%), mixed in one patient (3.1%), and uncharacterized in two (6.2%). Sepsis and multiple organ dysfunction were present in 31 subjects (96.9%). No risk factors for critical illness polyneuropathy could be identified although the study was not sufficiently powered to do so. The difference between serum micronutrient levels (copper, zinc, folate, and vitamin B12) between patients who developed polyneuropathy, and those who did not, was statistically insignificant.
CONCLUSIONS: We observed a high prevalence of critical illness polyneuropathy in children in PICU, mechanically ventilated for 7 days or more; almost all of whom had underlying sepsis.
| Errataetall: |
CommentIn: Pediatr Crit Care Med. 2019 Sep;20(9):888-889. - PMID 31483380 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2019 |
|---|---|
| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
|---|---|
| Enthalten in: |
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies - 20(2019), 9 vom: 01. Sept., Seite 826-831 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Shubham, Shantanu [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adrenal Cortex Hormones |
|---|
| Anmerkungen: |
Date Completed 03.08.2020 Date Revised 03.08.2020 published: Print CommentIn: Pediatr Crit Care Med. 2019 Sep;20(9):888-889. - PMID 31483380 Citation Status MEDLINE |
|---|
| doi: |
10.1097/PCC.0000000000002012 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM299598454 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM299598454 | ||
| 003 | DE-627 | ||
| 005 | 20231225100701.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2019 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/PCC.0000000000002012 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0998.xml |
| 035 | |a (DE-627)NLM299598454 | ||
| 035 | |a (NLM)31348111 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Shubham, Shantanu |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Polyneuropathy in Critically Ill Mechanically Ventilated Children |b Experience From a Tertiary Care Hospital in North India |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 03.08.2020 | ||
| 500 | |a Date Revised 03.08.2020 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Pediatr Crit Care Med. 2019 Sep;20(9):888-889. - PMID 31483380 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: To determine the prevalence of critical illness polyneuropathy and its risk factors in critically ill children mechanically ventilated for 7 days or more | ||
| 520 | |a DESIGN: Observational cohort study | ||
| 520 | |a SETTING: PICU of a tertiary care hospital from North India | ||
| 520 | |a PATIENTS: Children 1-15 years old admitted in PICU from June 2016 to September 2017, mechanically ventilated for 7 days or more, excluding those with diagnosed neuromuscular disease, stroke, or spinal pathology | ||
| 520 | |a INTERVENTION: Demographic details, diagnosis, treatment details, and anthropometry at admission and enrolment were recorded. Nerve conduction studies were performed after enrolment and repeated a week later, if the child was still in PICU. Medical Research Council scoring for muscle strength was performed in survivors. Risk factors including Pediatric Index of Mortality-2 score, sepsis, multiple organ dysfunction, hypoalbuminemia, use of steroids, neuromuscular-blocking agents, and vasopressors were recorded. Samples for the level of micronutrients (copper, zinc, folate, and vitamin B12) were collected at the time of enrolling the child and at the time of discharge | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: Thirty-two children were enrolled, of whom 29 had features of critical illness polyneuropathy on evaluation at day 8 of mechanical ventilation (prevalence, 90.6% [95% CI, 80.5-100%]). The polyneuropathy was axonal in 26 (81.2%), mixed in one patient (3.1%), and uncharacterized in two (6.2%). Sepsis and multiple organ dysfunction were present in 31 subjects (96.9%). No risk factors for critical illness polyneuropathy could be identified although the study was not sufficiently powered to do so. The difference between serum micronutrient levels (copper, zinc, folate, and vitamin B12) between patients who developed polyneuropathy, and those who did not, was statistically insignificant | ||
| 520 | |a CONCLUSIONS: We observed a high prevalence of critical illness polyneuropathy in children in PICU, mechanically ventilated for 7 days or more; almost all of whom had underlying sepsis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
| 650 | 7 | |a Vasoconstrictor Agents |2 NLM | |
| 700 | 1 | |a Dhochak, Nitin |e verfasserin |4 aut | |
| 700 | 1 | |a Singh, Akanksha |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Sanjay Kumar |e verfasserin |4 aut | |
| 700 | 1 | |a Chakrabarty, Biswaroop |e verfasserin |4 aut | |
| 700 | 1 | |a Sankar, Jhuma |e verfasserin |4 aut | |
| 700 | 1 | |a Gulati, Sheffali |e verfasserin |4 aut | |
| 700 | 1 | |a Kabra, S K |e verfasserin |4 aut | |
| 700 | 1 | |a Jaryal, Ashok Kumar |e verfasserin |4 aut | |
| 700 | 1 | |a Lodha, Rakesh |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies |d 2000 |g 20(2019), 9 vom: 01. Sept., Seite 826-831 |w (DE-627)NLM124299717 |x 1529-7535 |7 nnns |
| 773 | 1 | 8 | |g volume:20 |g year:2019 |g number:9 |g day:01 |g month:09 |g pages:826-831 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/PCC.0000000000002012 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 20 |j 2019 |e 9 |b 01 |c 09 |h 826-831 | ||