AI Summary & Key Takeaways
AI InsightThe neuromuscular symptoms developing as a result of critical illnesses reflect themselves as an increase in the hospitalization duration in the ICU, a difficulty in separation from the mechanical ventilator and an extension of rehabilitation.
📌 3 Key Takeaways
Abstract
Critical illness polyneuromyopathy (CIPNM) is a primary axonal-degenerative condition that occurs in sensory and motor fibers after the onset of a critical illness. It is thought that it develops due to tissue damage due to hypoxia/ischemia. When 24-year-old female patient was followed in the intensive care unit (ICU) due to diabetic ketoacidosis, she was extubated on the second day. She was reintubated on the third day because of respiratory acidosis. Sedation was withdrawn on the fifth day, however the patient could not recover consciousness until the 14th day and tetraplegia was found during her neurological examination. Motor peripheral nerve-transmission response in the upper- and lower-extremity was evaluated to be of low amplitude in the conducted needle electroneuromyography. The patient was weaned from mechanical ventilation on the 23rd day. The neuromuscular symptoms developing as a result of critical illnesses reflect themselves as an increase in the hospitalization duration in the ICU, a difficulty in separation from the mechanical ventilator and an extension of rehabilitation.
Özet
Kritik hastalık polinöromiyopatisi (KHPNM), kritik hastalık sonrası duyusal ve motor liflerde meydana gelen primer aksonal dejeneratif durumdur. Hipoksi/ iskemiye bağlı oluşan doku hasarı nedeniyle geliştiği düşünülmektedir. Yirmi dört yaşında kadın hasta diabetik ketoasidoz nedeni ile yoğun bakım ünitesinde (YBÜ) takip edilirken 2. gün ekstübe edildi. Üçüncü gün respiratuvar asidoz nedeniyle tekrar entübe edildi. Yatışının 5. günü sedasyonu kesilen hastanın bilinci 14. güne kadar açılmadı ve nörolojik muayenede tetrapleji tespit edildi. Yapılan iğne elektronöromiyografide üst ve alt ekstremite motor periferik sinir ileti yanıtları düşük amplitüdlü olarak değerlendirildi. Hasta 23. günde mekanik ventilasyondan ayrıldı. Kritik hastalıklara bağlı gelişen nöromusküler belirtiler kendisini YBÜsünde yatış süresinde uzama, mekanik ventilatörden ayrılmada güçlük ve uzamış rehabilitasyon olarak gösterebilir.