Is plasma calcium concentration implicated in the development of critical illness polyneuropathy and myopathy?
BACKGROUND
This prospective study investigated whether plasma ionized calcium concentration abnormalities and other electrolyte disturbances represent risk factors for the development of critical illness polyneuromyopathy (CIPNM) in ICU patients.


METHODS
One hundred and ninety consecutive adult critically ill patients with prolonged ICU stay (longer than 7 days) were prospectively evaluated. Patients with acute weakness and/or weaning difficulties were subjected to extensive electrophysiological measurements in order to establish the diagnosis of CIPNM. All recognized and/or possible risk factors for development of CIPNM were recorded.


RESULTS
The diagnosis of CIPNM was confirmed in 40 patients (21.05%). By applying a logistic regression model, hypocalcemia (P = 0.02), hypercalcemia (P = 0.01) and septic shock (P = 0.04) were independently associated with the development of CIPNM in critically ill patients.


CONCLUSIONS
We found that septic shock and abnormal fluctuations of plasma Ca²⁺ concentration represent significant risk factors for the development of CIPNM in critically ill patients.
Department of Physiology and Clinical Neurophysiology, School of Nursing, University of Athens, 8 Tetrapoleos Street, 11527 Goudi, Athens, Greece. danastas@nurs.uoa.gr
Dimitri
D
Anastasopoulos
Antonios
A
Kefaliakos
Argyris
A
Michalopoulos
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood*; D002128:Calcium Metabolism Disorders / Q000150:complications*; D016638:Critical Illness; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000097:blood / Q000209:etiology*; D011115:Polyneuropathies / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors; D014882:Water-Electrolyte Balance
D015415:Biomarkers; D002118:Calcium