Chest
Peripheral Nerve Function in Sepsis and Multiple Organ Failure
Section snippets
Definition of Patients and Entry Into the Study
Our retrospective studies6,13, 14, 15 were completed in 1983. This prospective study was approved by the Ethics Committee of the University of Western Ontario. During 14 months, 1,167 patients were admitted to the Victoria Hospital critical care unit. Three hundred and twenty-four were in the unit for longer than five days, a group which we believe to be at risk of developing sepsis and multiple organ failure. From this group, patients were entered who met the following criteria; (1) had
RESULTS
The 43 patients comprised 22 men and 21 women of mean age 64 (21 to 78) years. They presented with a variety of primary conditions (Table 1). At a mean of 28 (5 to 89) days, sepsis and multiple organ failure (Table 2) were first identified. The nerve function index was determined at this time and was abnormal in 30 patients, an incidence of 70 percent. The spread of abnormalities was relatively uniform, from the most severe neuropathy at 35 percent of normal function, to the least severe at 79
DISCUSSION
During the 14-month period of this prospective study, 43 patients were identified in our critical care unit who had sepsis and multiple organ failure and met entry criteria. This identification occurred at 28 (5 to 89) days after admission to the unit. The incidence of the polyneuropathy was 70 percent. However, due to the attendant endotracheal tube and the lingering effects of septic encephalopathy, the clinical examination to detect polyneuropathy was often unreliable. Thus, only half (15)
ACKNOWLEDGMENTS
We are grateful to Miss Betsy Toth, secretary, Mr. Anthony Parkes and Mrs. Deborah Laverty, electromyography technologists, and personnel in the Critical Care Unit.
REFERENCES (51)
- et al.
Multiple system organ failure
Surg Clin N Am
(1983) - et al.
Energy metabolism and proteolysis in traumatized and septic man
Surg Clin N Am
(1976) Multiple system organ failure
Surg Clin N Am
(1988)Multiple, progressive, or sequential systems failure: a syndrome of the 1970s
Arch Surg
(1975)- et al.
Determinants of organ malfunction or death in patients with intra-abdominal sepsis: a discriminant analysis
Arch Surg
(1983) Multiple system organ failure
Surg Clin N Am
(1988)Sepsis and septic shock - a synthesis of idea and proposals for the direction of future research
- et al.
Critical illness polyneuropathy: a complication of sepsis and multiple organ failure
Brain
(1987) - et al.
The encephalopathy of sepsis
Can J Neurol Sci
(1985) - et al.
The EEG in septic encephalopathy
Am EEG Soc
(1986)
Neurological complications in critically ill patients
Stimulation of muscle protein degradation and prostaglandin E2 release by leukocytic pyrogen (interleukin-1)
N Engl J Med
The electrophysiologic investigation of respiratory paralysis in critically ill patients
Neurology
Polyneuropathy in critically ill patients
J Neurol Neurosurg Psychiatr
Critically ill polyneuropathy: electrophysiological studies and differentiation from Guillain-Barre syndrome
J Neurol Neurosurg Psychiatr
Gentamicin-neurotoxizitat (polyneuropathie-enzephalopathie)
Schweiz Med Wschr
Neuromuscular complications in patients given Pavulon (pancuronium bromide) during artificial ventilation
Clin Neurol Neurosurg
Weaning failure due to acute neuromuscular disease
Crit Care Med
Peripheral neuropathy complicating pancreatitis and major pancreatic surgery
J Neurol Neurosurg Psychiatr
Prolonged respiratory insufficiency due to acute motor neuropathy: a new syndrome
Neurology
Polynevrites compliquant des. sejours prolonges en reanimation: a propos de 11 cas d'etiologie encore inconnue
Lyon Med
The neuropathy of the critically ill
Br Med J
Polyneurpathies au cours de sejours prolonges en reanimation
Rev Neurol
Critical illness polyneuropathy
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