Critical illness polyneuropathy - A 2-year follow-up study in 19 severe cases

Critical illness polyneuropathy (CIP) is a reported cause of varying degree s of neuromuscular weakness in patients with multiple organ failure. Little is known concerning predictive factors of neurological recovery. The criti cal care conditions, neurological explorations and 2-year clinical follow-u p of 19 patients who suffered from severe forms (quadriplegia or quadripare sis) of CIP were analyzed, Characteristics of patients who recovered clinic ally were compared with those of patients who did not. Two patients died wi thin 2 months, 11 recovered completely, 4 remained quadriplegic and 2 remai ned quadriparetic. All patients suffered from sepsis, multiple organ dysfun ction syndrome and a catabolic state before the onset of CIP, Outcome appea rs difficult to predict with clinical or electrophysiological data. Three p arameters were significantly correlated with poor recovery: longer length o f stay in the critical care unit, longer duration of sepsis and greater bod y weight loss. A relationship seems to exist between the severity of CIP an d that of sepsis and its associated hypercatabolism. The favorable outcome usually attributed to CIP must be reconsidered. The authors recommend aggre ssive measures against sepsis to limit CIP and its sequelae. Copyright (C) 2000 S. Karger AG, Basel.