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10.3390/jcm9124029
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Article

Simplified Diagnosis of Critical Illness Polyneuropathy in Patients with Prolonged Mechanical Ventilation: A Prospective Observational Cohort Study

by
Chul Jung
1,†,
Nak-Jun Choi
2,†,
Won Jun Kim
1,
Yoon Mok Chun
3,
Hak-Jae Lee
4,
Tae Hyun Kim
5,
Sae Rom Pak
4,
Jung Hoon Lee
1,
Suk-Kyung Hong
4,* and
Won Kim
1,*
1
Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
2
Division of Trauma Surgery, Department of Surgery, Korea University Guro Hospital, Seoul 08308, Korea
3
Wooridul Spine Hospital, Seoul 07505, Korea
4
Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea
5
Department of Surgery, Seoul Medical Center, Seoul 02053, Korea
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2020, 9(12), 4029; https://doi.org/10.3390/jcm9124029
Submission received: 30 October 2020 / Revised: 29 November 2020 / Accepted: 10 December 2020 / Published: 13 December 2020
(This article belongs to the Section Emergency Medicine)
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Abstract

Background: Although early identification of critical illness polyneuropathy (CIP) is necessary, the established diagnostic criteria have several limitations in the intensive care unit (ICU) setting. The purpose of this study was to define simplified diagnostic criteria of CIP that best predict clinical outcomes. Methods: This prospective, single-center study included 41 ICU patients with prolonged mechanical ventilation (≥21 days). We applied three different sets of diagnostic criteria (combining the results of the Medical Research Council (MRC) sum score and nerve conduction studies (NCS)) for CIP in order to identify the criteria with the best predictive power for clinical outcomes. Results: The simplified diagnosis of CIP meeting the criteria, i.e., that the MRC sum score < 48 and amplitudes of the tibial and sural nerve < 80% of the lower limit of normal, showed the strongest association with 0 ventilator-free days at day 60 (odds ratio, 6.222; p = 0.029). Conclusions: The diagnostic criteria combining the MRC sum score and the tibial and the sural NCS were identified as the simplified criteria of CIP that best predicted the clinical outcomes. The implementation of these simplified criteria may allow for early identification of CIP in the ICU, thereby contributing to prompt interventions for patients with a poor prognosis.
Keywords: critical illness polyneuropathy; simplified diagnosis; electrophysiology; clinical outcomes; mechanical ventilation critical illness polyneuropathy; simplified diagnosis; electrophysiology; clinical outcomes; mechanical ventilation

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MDPI and ACS Style

Jung, C.; Choi, N.-J.; Kim, W.J.; Chun, Y.M.; Lee, H.-J.; Kim, T.H.; Pak, S.R.; Lee, J.H.; Hong, S.-K.; Kim, W. Simplified Diagnosis of Critical Illness Polyneuropathy in Patients with Prolonged Mechanical Ventilation: A Prospective Observational Cohort Study. J. Clin. Med. 2020, 9, 4029. https://doi.org/10.3390/jcm9124029

AMA Style

Jung C, Choi N-J, Kim WJ, Chun YM, Lee H-J, Kim TH, Pak SR, Lee JH, Hong S-K, Kim W. Simplified Diagnosis of Critical Illness Polyneuropathy in Patients with Prolonged Mechanical Ventilation: A Prospective Observational Cohort Study. Journal of Clinical Medicine. 2020; 9(12):4029. https://doi.org/10.3390/jcm9124029

Chicago/Turabian Style

Jung, Chul, Nak-Jun Choi, Won Jun Kim, Yoon Mok Chun, Hak-Jae Lee, Tae Hyun Kim, Sae Rom Pak, Jung Hoon Lee, Suk-Kyung Hong, and Won Kim. 2020. "Simplified Diagnosis of Critical Illness Polyneuropathy in Patients with Prolonged Mechanical Ventilation: A Prospective Observational Cohort Study" Journal of Clinical Medicine 9, no. 12: 4029. https://doi.org/10.3390/jcm9124029

APA Style

Jung, C., Choi, N.-J., Kim, W. J., Chun, Y. M., Lee, H.-J., Kim, T. H., Pak, S. R., Lee, J. H., Hong, S.-K., & Kim, W. (2020). Simplified Diagnosis of Critical Illness Polyneuropathy in Patients with Prolonged Mechanical Ventilation: A Prospective Observational Cohort Study. Journal of Clinical Medicine, 9(12), 4029. https://doi.org/10.3390/jcm9124029

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