Causes of сritical illness polyneuropathy in adults after cardiac surgery

Abstract

Background: Critical illness polyneuropathy (CIP) is the most common complication of peripheral nervous system after cardiac surgery. Тhe aim of the research was to determine the cause of critical illness polyneuropathy in the patients who had operations on the heart. Material and methods: The study included 55 patients (32 men, 23 women) who underwent of surgery on the heart with cardiopulmonary bypass. Patients underwent coronary artery bypass grafting in 52.7% of cases; reconstructive surgery on the heart valves in 47.3% of cases. Patients had characteristics comparable age and sex. All patients used Sevaran as anesthesia. All patients were assessed preoperative, intraoperative and postoperative characteristics. Stimulation EMG was performed before the operation and on the 7th day after surgery. Estimated amplitude of the M-response to the speed of motor and sensory fibers, F-wave. Results: 15 patients (7 - men, 8 - women) after heart surgery debuted сritical illness polyneuropathy confirmed by EMG. Patients with signs of polyneuropathy in the postoperative period in 100% of cases had multiple organ failure syndrome and systemic inflammatory response, (p < 0,01). These patients were longer in the intensive care unit, (p < 0,05), longer they were held ventilation, more often required inotropic support, (p < 0,05) and more likely to suffer pneumonia, (p < 0,05). Conclusions: Critical illness polyneuropathy can develop in patients that have undergone heart surgery with cardiac bypass as the result of multiple organ injury syndrome and systemic inflammation response syndrome. Comorbidity background, types of heart surgery, the technique of surgical intervention, especially of anesthetic, duration of respiratory care, inotropic support and sedation are not the cause of critical illness polyneuropathy in patients undergoing heart surgery.