gms | German Medical Science

Background: Critical illness polyneuropathy is an important complication in intensive care unit patients. Prolonged mechanical ventilation has been associated with the prevalence of CIPN. Phrenic nerve conduction results are highly relevant to the date of weaning from the ventilator. In addition, it is hard to perform a full electrophysiologic study for CIPN diagnosis in critically ill patients.

Aim: The aim of this study is to recognize the correlation between the CIPN and patient’s prognosis when simplified diagnostic criteria are applied.

Method: Critically ill patients, who were mechanically ventilated for ≥3 weeks were included. At 3 weeks of mechanical ventilation on ICU patients, they were subjected to the NCS in upper, lower extremities including phrenic nerve. We employed three versions of the diagnostic criteria depending on the MRC scale and NCS result. We used ventilator-free days to compare the patient’s prognosis. A ventilator-free day ≥1 day was defined as a good prognosis and 0 day was defined as a bad prognosis. Then, we evaluated the correlation between the prevalence of CIPN and patient’s prognosis.

Results/findings: A total of 50 patients were enrolled in the study — the diagnosis of CIPN yielded as the following: 7 of 50 according to criteria A; 13 of 50 according to criteria B; 16 of 50 according to criteria C. As the authors diagnose CIPN on patients by criteria A, B, and C, respectively, the results bring forth the following: CIPN patients according to criteria A yields an odds ratio of 12.1, regarding the prognosis detrimental to patients; an odds ratio of 24.0 by criteria B, and an odds ratio of 12.4 by criteria C.

Discussion and conclusions: Our results suggest that the diagnostic criteria of MRC in conjunction with the tibial and sural nerve conduction study show the most predictive value on the patient’s prognosis.