Intensive Care Unit-Acquired Weakness in Children: A Prospective Observational Study Using Simplified Serial Electrophysiological Testing (PEDCIMP Study).
Neurocrit Care
; 34(3): 927-934, 2021 06.
Article
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| MEDLINE
| ID: mdl-33025545
ABSTRACT
BACKGROUND:
To study the incidence and time of onset of intensive care unit-acquired weakness in a prospective cohort of children (2-12 years) by serial simplified electrophysiological assessment (Pediatric Critical Illness Myopathy Polyneuropathy study, PEDCIMP).METHODS:
A single-center, prospective cohort study (Trial Registry Number NCT02763709; PEDCIMP2016) was conducted at the pediatric intensive care unit of a tertiary care hospital in North India. A complete electrophysiological evaluation (4 motor nerves and 2 sensory nerves) was performed at baseline in children (2-12 years) admitted to the ICU with a pediatric risk of mortality (PRISM) of > 20 with more than 24-h stay. Following the entry evaluation, a minimal alternate day simplified electrophysiological testing of the unilateral common peroneal nerve and the sural nerve was assessed. A 25% reduction in compound muscle action potential (CMAP) and sensory nerve action potential from baseline was considered significant for ICUAW and was confirmed by complete electrophysiological re-evaluation.RESULTS:
Of the total 481 children assessed for eligibility, 97 were enrolled. The median age of the cohort was 7 years. Sepsis (81%); need for vasoactive support (43%); multiorgan dysfunction (26%) were the common reasons for admission. Of the 433 eligible patient ICU days, 380 electrophysiological observations were done. A significant decrease of > 25% in CMAP of common peroneal nerve was not detected in any of the 380 observations. However, two children unfit for inclusion were diagnosed with ICUAW during the study period.CONCLUSIONS:
Children admitted with PRISM > 20 have a very low incidence of intensive care unit-acquired weakness by serial clinical and abbreviated electrophysiological evaluation.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Polineuropatías
/
Enfermedad Crítica
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
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Risk_factors_studies
Límite:
Child
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Child, preschool
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Humans
Idioma:
En
Revista:
Neurocrit Care
Asunto de la revista:
NEUROLOGIA
/
TERAPIA INTENSIVA
Año:
2021
Tipo del documento:
Article
País de afiliación:
India