Critical illness polyneuropathy and myopathy in pediatric intensive care: A review.
OBJECTIVE
To review the medical literature on critical illness polyneuropathy and myopathy in childhood.


METHODS
Medline and EMBASE were searched using the following terms: critical illness (neuropathy, polyneuropathy, and myopathy), critical care (neuropathy, polyneuropathy, and myopathy), acute myopathy, acute necrotizing myopathy, children, and pediatric. The references listed in publications thus identified were also reviewed.


METHODS
All studies relating to pediatric critical illness polyneuropathy and myopathy were included. The adult literature was also reviewed as to the current understanding of critical illness polyneuropathy and myopathy.


RESULTS
Critical illness polyneuropathy and critical illness myopathy are well recognized in adults, in whom they commonly cause generalized weakness and muscle wasting, with failure to wean from mechanical ventilation. Critical illness polyneuropathy and critical illness myopathy are reported in 32-100% of critically ill adult patients ventilated for >3 days. There is significant clinical and neurophysiologic overlap between the two conditions, such that the term critical illness polyneuropathy and myopathy (CIPNM) is often used. Critical illness polyneuropathy and critical illness myopathy have only occasionally been reported in childhood, and little is known of their prevalence or clinical significance in this population. This article summarizes the pediatric literature on critical illness polyneuropathy and critical illness myopathy and highlights areas for future research in critically ill children.


CONCLUSIONS
Critical illness polyneuropathy and myopathy may cause significant morbidity in critically ill children. These conditions seem to be clinically and electrophysiologically similar in children and adults, but prospective studies of these entities are required to better characterize their frequency, natural history, and clinical significance in pediatric practice.
Williams
Stephen
S
Helen McMillan Paediatric Intensive Care Unit, The Children's Hospital at Westmead, NSW, Australia.
Horrocks
Iain A
IA
Ouvrier
Robert A
RA
Gillis
Jonathan
J
Ryan
Monique M
MM
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003402:Creatine Kinase / Q000097:blood; D016638:Critical Illness; D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009135:Muscular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D009482:Neurophysiology; D011115:Polyneuropathies / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D003402:Creatine Kinase