Department of Physiology and Clinical Neurophysiology, School of Nursing, University of Athens, 8 Tetrapoleos Street, 11527 Goudi, Athens, Greece.
Crit Care. 2011;15(5):R247. doi: 10.1186/cc10505. Epub 2011 Oct 21.
This prospective study investigated whether plasma ionized calcium concentration abnormalities and other electrolyte disturbances represent risk factors for the development of critical illness polyneuromyopathy (CIPNM) in ICU patients.
One hundred and ninety consecutive adult critically ill patients with prolonged ICU stay (longer than 7 days) were prospectively evaluated. Patients with acute weakness and/or weaning difficulties were subjected to extensive electrophysiological measurements in order to establish the diagnosis of CIPNM. All recognized and/or possible risk factors for development of CIPNM were recorded.
The diagnosis of CIPNM was confirmed in 40 patients (21.05%). By applying a logistic regression model, hypocalcemia (P = 0.02), hypercalcemia (P = 0.01) and septic shock (P = 0.04) were independently associated with the development of CIPNM in critically ill patients.
We found that septic shock and abnormal fluctuations of plasma Ca²⁺ concentration represent significant risk factors for the development of CIPNM in critically ill patients.
本前瞻性研究旨在探讨 ICU 患者的血浆离子钙浓度异常和其他电解质紊乱是否为危重病多发性神经病（CIPNM）发展的危险因素。
对 190 例 ICU 住院时间延长（超过 7 天）的成年危重症患者进行前瞻性评估。对急性无力和/或撤机困难的患者进行广泛的电生理测量，以确定 CIPNM 的诊断。记录所有公认的和/或可能导致 CIPNM 发展的危险因素。
40 例（21.05%）患者确诊为 CIPNM。通过应用逻辑回归模型，低钙血症（P=0.02）、高钙血症（P=0.01）和感染性休克（P=0.04）与危重症患者 CIPNM 的发生独立相关。
我们发现感染性休克和血浆 Ca²⁺浓度的异常波动是危重症患者发生 CIPNM 的重要危险因素。
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