Intensive care unit acquired weakness in children: Critical illness polyneuropathy and myopathy

Vinay Kukreti; Mosharraf Shamim; Praveen Khilnani

doi:10.4103/0972-5229.126079

Intensive care unit acquired weakness in children: Critical illness polyneuropathy and myopathy

Indian J Crit Care Med. 2014 Feb;18(2):95-101. doi: 10.4103/0972-5229.126079.

Authors

Vinay Kukreti¹, Mosharraf Shamim², Praveen Khilnani³

Affiliations

¹ Departments of Critical Care, Pediatric Critical Care Unit, The Hospital for Sick Children, Toronto, Canada.
² Department of Pediatric Critical Care King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
³ Pediatric Critical Care Unit, BLK Superspeciality Hospital, New Delhi.

Abstract

Background and aims: Intensive care unit acquired weakness (ICUAW) is a common occurrence in patients who are critically ill. It is most often due to critical illness polyneuropathy (CIP) or to critical illness myopathy (CIM). ICUAW is increasingly being recognized partly as a consequence of improved survival in patients with severe sepsis and multi-organ failure, partly related to commonly used agents such as steroids and muscle relaxants. There have been occasional reports of CIP and CIM in children, but little is known about their prevalence or clinical impact in the pediatric population. This review summarizes the current understanding of pathophysiology, clinical presentation, diagnosis and treatment of CIP and CIM in general with special reference to published literature in the pediatric age group.

Subjects and methods: Studies were identified through MedLine and Embase using relevant MeSH and Key words. Both adult and pediatric studies were included.

Results: ICUAW in children is a poorly described entity with unknown incidence, etiology and unclear long-term prognosis.

Conclusions: Critical illness polyneuropathy and myopathy is relatively rare, but clinically significant sequelae of multifactorial origin affecting morbidity, length of intensive care unit (ICU) stay and possibly mortality in critically ill children admitted to pediatric ICU.

Keywords: Children; critical illness myopathy; critical illness polyneuropathy; intensive care unit; intensive care unit acquired weakness; pediatric.