[Neuromuscular disorders in critically ill patients].
OBJECTIVE
Critically ill patients admitted to the Intensive Care Unit (ICU) often develop neuromuscular disorders. The objective of this study was to diagnose these and determine the causes.


METHODS
We present a series of 13 critically ill patients who developed weakness or paresia, reduced or absent ROT and normal brain stem reflexes, in whom ENG and EMG studies were done in EESS and II which were considered together with data from general laboratory analysis, radiological and microbiological examinations, medication given and posterior clinical course of the patient. Muscle biopsy was not done in any patient.


RESULTS
All the patients were intubated, with signs of sepsis, multiple-organ failure and malnutrition. All had received cortico-steroids and amino-glucosides and 8/13 neuromuscular blockers. Neurophysiological study showed that in all cases there was axon type neuropathy, mainly motor and in the lower limbs. Fifty four percent of the patients died. The neuropathy improved in the others.


CONCLUSIONS
Critically ill patients often have axon type neuropathy. In our series, the causes of this were sepsis and multiple organ failure. It is important that this pathology be ruled out in the critically ill patient whom it is difficult to disintubate and/or has generalized muscle weakness.
Gurtubay
I G
IG
Servicio de Neurofisiologia Clínica, Hospital Virgen del Camino, Pamplona, España.
Morales
G
G
Navajas
D
D
Carrera
B
B
Iragui
M
M
D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001369:Axons / Q000473:pathology*; D003422:Critical Care; D016638:Critical Illness; D004576:Electromyography; D004584:Electronystagmography; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D009102:Multiple Organ Failure / Q000175:diagnosis; D009466:Neuromuscular Blocking Agents / Q000627:therapeutic use; D012189:Retrospective Studies; D018805:Sepsis / Q000175:diagnosis; D013256:Steroids
D000617:Aminoglycosides; D000893:Anti-Inflammatory Agents; D009466:Neuromuscular Blocking Agents; D013256:Steroids
Alteraciones neuromusculares del paciente crítico.