Differentiation of Critical Illness Myopathy and Critical Illness Neuropathy Using Nerve Ultrasonography.
J Clin Neurophysiol
; 40(7): 600-607, 2023 Nov 01.
Article
en En
| MEDLINE
| ID: mdl-35089907
ABSTRACT
PURPOSE:
Intensive care unit-acquired weakness occurs frequently in intensive care unit patients, including critical illness myopathy (CIM) and critical illness polyneuropathy (CIPN). The authors present a prospective study to assess the ultrasound pattern sum score to differentiate between confirmed CIM, sensory neuropathy, and CIPN cases.METHODS:
Cross-sectional areas of 12 predefined nerve segments in 16 patients were sonographically examined. Single-nerve cross-sectional areas and ultrasound pattern sum score values were compared; results are given as P -values and receiver operating characteristic area under the curve (AUC).RESULTS:
In neuropathy, significant single-nerve cross-sectional area enlargement was observed in the median ( P = 0.04), ulnar ( P = 0.04), and fibular nerves ( P = 0.0003). The ultrasound pattern sum score could reliably differentiate between pure CIM and neuropathy ( P = 0.0002, AUC 0.92), CIM and sensory neuropathy ( P = 0.001, AUC 0.88), and CIM and CIPN ( P = 0.007, AUC 0.92), but not between sensory neuropathy and CIPN ( P = 0.599, AUC 0.48).CONCLUSIONS:
Nerve ultrasonography reliably identifies neuropathy in intensive care unit-acquired weakness, yet cannot differentiate between sensory neuropathy and CIPN. A standardized ultrasound algorithm can serve as a fast bedside test for the presence of neuropathy in intensive care unit-acquired weakness.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Polineuropatías
/
Enfermedades del Sistema Nervioso Periférico
/
Enfermedades Musculares
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
J Clin Neurophysiol
Asunto de la revista:
FISIOLOGIA
/
NEUROLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Austria