81. Clinical and electrophysiological findings in critically ill paediatric patients

Abstract

To describe clinical and electrophysiological features in critically ill paediatric patients. Acquired neuromuscular weakness due to critical illness polyneuropathy (CIP)- which could develop during a severe illness requiring intensive care- has been rarely described in childhood, but it’s likely to occur more often than previously thought. A case series of critically ill neonates and children admitted and hospitalized for more than 1 week into Paediatric Intensive Care Unit (PICU) was observed prospectively. Selected clinical and laboratory parameters were evaluated. Conduction velocities studies were performed during the first week, and then repeated during the second, third and fourth week in order to detect sign of CIP. Clinically muscle weakness could not be easily evaluated in critical ill neonates and sensory loss is often difficult to assess in children and especially in those sedated or intubated. CIP is less common in children than in adult, but early electrophysiological investigations could help to detect this condition or to discover rare neuromuscular diseases, as very early onset hereditary polyneuropathy. We propose electrophysiological examination as an available method to detect CIP in childhood -in order to avoid unnecessary diagnostic procedures- and a screening tool in studies of critically ill children with implications for the diagnosis and management of paediatric intensive care survivors.