title: [Polyneuropathy in critically ill patients: a seldom recognized cause of dependence on mechanical ventilators].
abstract: BACKGROUND
  Neuromuscular complications, in a critical care unit, are a cause of morbidity in children and prolonged dependence on a mechanical ventilator. Polyneuropathy of the critical patient is such a complication and is seen in patients on mechanical respiratory assistance.
  
  
  OBJECTIVE
  To discuss the neurological and electrophysiological clinical findings of polyneuropathy of the critical patient.
  
  
  METHODS
  We evaluated four patients who initially required mechanical respiratory assistance, three for lung disorders and one for acute encephalopathy, who developed prolonged dependence on mechanical ventilators in the year 1999. In all these patients electromyography showed primary axon nerve disorders with secondary demyelination of all four limbs and phrenic nerve involvement.
  
  
  CONCLUSIONS
  Clinical suspicion and use of suitable electrophysiological techniques permits identification of this condition in the severely ill paediatric patient. Better recognition of the condition and investigation of the etiological factors would help to develop suitable measures for prevention and treatment.
authors: Servicio de Neurología, Hospital Nacional de Pediatría Profesor Dr Juan P. Garrahan, Buenos Aires, Argentina. miranda@intramed.net.ar
authors: M
authors: M
authors: Miranda
authors: H A
authors: HA
authors: Arroyo
authors: D
authors: D
authors: Ledesma
authors: J
authors: J
authors: Sasbon
authors: C
authors: C
authors: Medina
authors: N
authors: N
authors: Fejerman
mesh_terms: D001284:Atrophy / Q000473:pathology; D001369:Axons / Q000473:pathology; D002648:Child; D016638:Critical Illness; D003711:Demyelinating Diseases / Q000473:pathology; D003964:Diaphragm / Q000503:physiopathology; D004576:Electromyography / Q000295:instrumentation; D020803:Encephalitis, Herpes Simplex / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000150:complications / Q000503:physiopathology; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology / Q000503:physiopathology; D009130:Muscle, Smooth / Q000503:physiopathology; D009468:Neuromuscular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010791:Phrenic Nerve / Q000473:pathology / Q000503:physiopathology; D012121:Respiration, Artificial / Q000009:adverse effects*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors