Neurophysiologic variables as prognosticators in outcome of ventilated patient
Keywords:
mechanical ventilation, outlet mechanical ventilation, neurophysiological studies, neuroconduction, polyneuropathy, critical patient, APACHE II, NUTRIC score, SOFAAbstract
Introduction: Many ventilated patients in intensive care units develop neuromuscular dysfunction causing difficulties in the outcome of ventilation. Peripheral neuropathy is the most frequent of all peripheral neuromuscular damages, being difficult it’s managed by means of physical exam, but the neurophysiologic studies prevent the affection detecting it early.
Objective: Determine neurophysiological variables with prognostic value in the outcome of the mechanic ventilation and identify association of these variables and scales assessing severity of disease with botched outcome.
Methods: Conductions of peroneal and phrenic nerves were studied and the BMI, CONUT, NUTRIC score, APACHE, SOFA, amine and steroid dose were assessed. Patients were grouped according the outlet of ventilation. Association were established between neurophysiological variables (latency and amplitude of CMAP and MCV) and the rest of variables. It was obtained a court point for amplitude of CMAP useful as reference value in the prognostic of mechanical ventilation outcome.
Results: Botched outcome of ventilation was associated with decreased CMAP amplitude of phrenic nerve, with 135 µV court point for it (sensibility 63.0% and specificity 64.1%). There were not significant differences between botched outcome group and successful outcome group about polyneuropathy, age, sex, pathological background, medical admission and toxic habits.
Conclusions: Amplitude of phrenic nerve CAMP is an indicator of prognostic for outcome of mechanical ventilation.
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