P-PN010. Critical illness Polyneuropathy

Introduction. Critical Illness Polyneuropathy (CIP) is a frequent complication of critical illness, acutely and primarily affecting the motor and sensory axons. CIP delays weaning from mechanical ventilation, increases the length of stay at the intensive care unit, compromises rehabilitation and may result in a lifelong loss of function and in a reduction in quality of life. Greater than 50% of patients mechanically ventilated for more than 7 days will develop electrophysiological abnormalities with 25-33% developing clinically overt weakness. Until recently, no therapeutic measures had been proven to affect its incidence, and apart from supportive treatment. Results. A 52-year-old chinese lady presented to ED with shortness of breath due to SIRS et. causa pneumonia was consulted to neurology department because of loss of conciousness. After being intubated, patient awakened within stable condition. On neurological examination, there were bilateral ptosis, bilateral ophthalmoplegia, flaccid over all extremities, decrease of tendon reflexes and sensory were intact. There were leukocytosis and respiratory acidosis on laboratory findings. Chest X-ray noticed bilateral minimal pleural effusion and cardiomegaly. Bronchoscopy and Thorax CT-scan found inflammation. Abdominal ultrasound and head CT scan were within normal limits. Lumbar puncture was not done due to rejection from the family. On EDX findings, NCS found axonal loss pattern in motor and sensory, RNS was within normal limits and needle EMG findings noted distal pattern of decreased recruitment with denervation. After 18 months being hospitalised in ICU and using mechanical ventilator, the patient died. Conclusion. There is no direct treatment for CIP. CIP results in substantial morbidity, mortality, costs and could likely be improved with earlier diagnosis and more timely intervention. To achieve this goal, however, more awareness on the part of medical establishment is needed, as well as further research into the causes of treatments for CIP.