Electrophysiology characteristic of critical illness polyneuromyopathy and its effect on the duration of mechanical ventilation
10.3760/cma.j.issn.1006-7876.2009.03.004
- VernacularTitle:危重病性多发性神经肌病电生理特点及对机械通气的影响
- Author:
Zhecheng ZHANG
;
Na LIU
;
Bin LI
;
Guoping XING
- Publication Type:Journal Article
- Keywords:
Polyneuropathies;
Muscular diseases;
Electrophysiology;
Respiratio,artificial
- From:
Chinese Journal of Neurology
2009;42(3):157-160
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the electrophysiologie characteristics of critical illness of polyneuromyopathy ( CIPM ) and its effect on the duration of usage of mechanical ventilation. Methods Denmark Keypoint 4-electromyogram was utilized to record electraneurophysiology on 17 subjects with lung infection and respiratory failure who were treated with mechanical ventilation over 1 week and had difficulty in weaning from the ventilator in intensive care unit. Electrophysiology character of CIPM was described and the duration of mechanical ventilation of CIPM patients was compared with non-CIPM subjects. ResultsOf the 17 cases, 9 subjects were diagnosed with CIPM including 6 patients with critical illness polyneuropathy (CIP), and 3 patients with critical illness myopathy (CIM), the 2 subtype of CIPM. Compound muscle action potential (CMAP) and sympathetic skin response (SSR) in all of CIPM patients were abnormaL Though the amplitude of sensory nerve action potential (SNAP) in patients with CIP was reduced, nerve conduction velocity (NCV) was normal in all of them. Repetitive nerve stimulation, somatosensory evoked potential and blink reflex were normal in all of the patients with CIPM, however, the rate of occurrence of F wave was reduced in 2 patients with CIP and in 2 patients with CIM. The median and quartile range of duration of mechanical ventilation in CIPM patients was 30. 0 days (20. 0--45.0 days), significantly longer than13.5 days (9.5--17.5 days) in non-CIPM patients (U=7.500,P=0.006). ConclusionsThe ehctrophysiology change in patients with CIPM is characterized by reduced amplitude of CMAP and (or) SNAP, normal NCV and abnormal SSR. The duration of mechanical ventilation is significantly prolonged in CIPM patients.
