Incidence and risk factors of peripheral nerve injuries 3 months after ICU discharge: a retrospective study comparing COVID-19 and non-COVID-19 critically ill survivors.
COVID-19; Critical illness; Follow-up clinic; Glucocorticoids; Peripheral nerve injury; General Medicine
Abstract :
[en] [en] BACKGROUND: Peripheral nerve injuries (PNI) have been associated with prone positioning (PP) in mechanically ventilated (MV) patients with COVID-19 pneumonia. The aims of this retrospective study were to describe PNI prevalence 3 months (M3) after intensive care unit (ICU) discharge, whether patients survived COVID-19 or another critical illness, and to search for risk factors of PNI.
RESULTS: A total of 55 COVID (62 [54-69] years) and 22 non-COVID (61.5 [48-71.5] years) patients were followed at M3, after an ICU stay of respectively 15 [9-26.5] and 13.5 [10-19.8] days. PNI symptoms were reported by 23/55 (42.6%) COVID-19 and 8/22 (36%) non-COVID-19 patients (p = 0.798). As the incidence of PNI was similar in both groups, the entire population was used to determine risk factors. The MV duration predicted PNI occurrence (OR (CI95%) = 1.05 (1.01-1.10), p = 0.028), but not the ICU length of stay, glucocorticoids, or inflammation biomarkers.
CONCLUSION: In the present cohort, PNI symptoms were reported in at least one-third of the ICU survivors, in similar proportion whether patients suffered from severe COVID-19 or not.
Disciplines :
Anesthesia & intensive care
Author, co-author :
MALENGREAUX, Christophe ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
MINGUET, Pauline ; Centre Hospitalier Universitaire de Liège - CHU > > Service des soins intensifs
COLSON, Camille ; Centre Hospitalier Universitaire de Liège - CHU > > Soins intensifs chirurgie (+1D)
Dardenne, Nadia ; Université de Liège - ULiège > Département des sciences de la santé publique
Misset, Benoît ; Centre Hospitalier Universitaire de Liège - CHU > > Service des soins intensifs
Rousseau, Anne-Françoise ; Centre Hospitalier Universitaire de Liège - CHU > > Service des soins intensifs
Language :
English
Title :
Incidence and risk factors of peripheral nerve injuries 3 months after ICU discharge: a retrospective study comparing COVID-19 and non-COVID-19 critically ill survivors.
Publication date :
09 February 2024
Journal title :
Journal of Anesthesia, Analgesia and Critical Care
L.R. Robinson Traumatic injury to peripheral nerves Muscle Nerve juin 2000 23 6 863 873 1:STN:280:DC%2BD3czgtlSjtg%3D%3D 10.1002/(SICI)1097-4598(200006)23:6<863::AID-MUS4>3.0.CO;2-0
M. Swash M. de Carvalho Intensive care unit-acquired weakness: neuropathology J Clin Neurophysiol mai 2020 37 3 197 199 10.1097/WNP.0000000000000660
C.F. Bolton D.A. Laverty J.D. Brown N.J. Witt A.F. Hahn W.J. Sibbald Critically ill polyneuropathy: electrophysiological studies and differentiation from Guillain-Barré syndrome J Neurol Neurosurg Psychiatry mai 1986 49 5 563 573 1:STN:280:DyaL283is1egsw%3D%3D 10.1136/jnnp.49.5.563
D.W. Zochodne C.F. Bolton G.A. Wells J.J. Gilbert A.F. Hahn J.D. Brown et al. Critical illness polyneuropathy. A complication of sepsis and multiple organ failure Brain J Neurol 1987 110 4 819 41 10.1093/brain/110.4.819
N. Latronico C.F. Bolton Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis Lancet Neurol 2011 10 10 931 941 10.1016/S1474-4422(11)70178-8 21939902
R.D. Stevens D.W. Dowdy R.K. Michaels P.A. Mendez-Tellez P.J. Pronovost D.M. Needham Neuromuscular dysfunction acquired in critical illness: a systematic review Intensive Care Med 2007 33 11 1876 1891 10.1007/s00134-007-0772-2 17639340
F.S. Leijten A.W. De Weerd D.C. Poortvliet V.A. De Ridder C. Ulrich J.E. Harink-De Weerd Critical illness polyneuropathy in multiple organ dysfunction syndrome and weaning from the ventilator Intensive Care Med 1996 22 9 856 861 1:STN:280:DyaK2s%2FmtFertQ%3D%3D 10.1007/BF02044107 8905417
S.B. Schmidt J.D. Rollnik Critical illness polyneuropathy (CIP) in neurological early rehabilitation: clinical and neurophysiological features BMC Neurol 2016 16 1 256 10.1186/s12883-016-0775-0 27978832 5160009
K. Hokkoku C. Erra C. Cuccagna D. Coraci D.M. Gatto D. Glorioso et al. Intensive care unit-acquired weakness and positioning-related peripheral nerve injuries in COVID-19: a case series of three patients and the latest literature review Brain Sci 2021 11 9 1177 1:CAS:528:DC%2BB3MXitFygu7nL 10.3390/brainsci11091177 34573198 8470888
B. Lambermont A.F. Rousseau L. Seidel M. Thys J. Cavalleri P. Delanaye et al. Outcome improvement between the first two waves of the coronavirus disease 2019 pandemic in a single tertiary-care hospital in Belgium Crit Care Explor mai 2021 3 5 e0438 10.1097/CCE.0000000000000438
A. Maury A. Lyoubi N. Peiffer-Smadja T. de Broucker E. Meppiel Neurological manifestations associated with SARS-CoV-2 and other coronaviruses: a narrative review for clinicians Rev Neurol (Paris) 2021 177 1–2 51 64 1:STN:280:DC%2BB3srgt12lsg%3D%3D 10.1016/j.neurol.2020.10.001 33446327
G.R. Malik A.R. Wolfe R. Soriano L. Rydberg L.F. Wolfe S. Deshmukh et al. Injury-prone: peripheral nerve injuries associated with prone positioning for COVID-19-related acute respiratory distress syndrome Br J Anaesth déc 2020 125 6 e478 e480 1:CAS:528:DC%2BB3cXhvVGhur%2FJ 10.1016/j.bja.2020.08.045
Barton EC, Crosbie G, Hobson S, Harvey J, Abu-Arafeh A, Livesey JA et al (2023) A critical care follow-up service evaluation: acquired peripheral nerve injury after admission with COVID-19 respiratory disease. J Intensive Care Soc 24(2):230–1
L. Cabañes-Martínez M. Villadóniga L. González-Rodríguez L. Araque A. Díaz-Cid I. Ruz-Caracuel et al. Neuromuscular involvement in COVID-19 critically ill patients Clin Neurophysiol Off J Int Fed Clin Neurophysiol. 2020 131 12 2809 2816 10.1016/j.clinph.2020.09.017
C. Iadecola J. Anrather H. Kamel Effects of COVID-19 on the nervous system Cell. 2020 183 1 16 27.e1 1:CAS:528:DC%2BB3cXhslygsLjL 10.1016/j.cell.2020.08.028 32882182 7437501
RECOVERY Collaborative Group; Horby P, Lim WS, Emberson JR, Mafham M, Bell JL, Linsell L, Staplin N, Brightling C, Ustianowski A, Elmahi E, Prudon B, Green C, Felton T, Chadwick D, Rege K, Fegan C, Chappell LC, Faust SN, Jaki T, Jeffery K, Montgomery A, Rowan K, Juszczak E, Baillie JK, Haynes R, Landray MJ (2021) Dexamethasone in Hospitalized Patients with Covid-19. N Engl J Med 384(8):693–704.
J. Vandewalle A. Luypaert K. De Bosscher C. Libert Therapeutic mechanisms of glucocorticoids Trends Endocrinol Metab TEM janv 2018 29 1 42 54 1:CAS:528:DC%2BC2sXhsl2ltL%2FM 10.1016/j.tem.2017.10.010
B. De Jonghe T. Sharshar J.P. Lefaucheur F.J. Authier I. Durand-Zaleski M. Boussarsar et al. Paresis acquired in the intensive care unit: a prospective multicenter study JAMA 2002 288 22 2859 2867 10.1001/jama.288.22.2859 12472328
G. Van den Berghe K. Schoonheydt P. Becx F. Bruyninckx P.J. Wouters Insulin therapy protects the central and peripheral nervous system of intensive care patients Neurology 2005 64 8 1348 1353 10.1212/01.WNL.0000158442.08857.FC 15851721
C. Guérin R.K. Albert J. Beitler L. Gattinoni S. Jaber J.J. Marini et al. Prone position in ARDS patients: why, when, how and for whom Intensive Care Med 2020 46 12 2385 2396 10.1007/s00134-020-06306-w 33169218 7652705
M. Bringer L. Gay C. Gorun A. Hassaine F. Molimard A. Noui et al. Le décubitus ventral: de la théorie à la pratique Médecine Intensive Réanimation. 2019 28 1 52 59 10.3166/rea-2018-0065
C. Collin D.T. Wade S. Davies V. Horne The Barthel ADL Index: a reliability study Int Disabil Stud 1988 10 2 61 63 1:STN:280:DyaL1c3pvVKhsQ%3D%3D 10.3109/09638288809164103 3403500
S. Koch S. Spuler M. Deja J. Bierbrauer A. Dimroth F. Behse et al. Critical illness myopathy is frequent: accompanying neuropathy protracts ICU discharge J Neurol Neurosurg Psychiatry. 2011 82 3 287 293 10.1136/jnnp.2009.192997 20802220
G. Hermans G. Van den Berghe Clinical review: intensive care unit acquired weakness Crit Care 2015 19 1 274 10.1186/s13054-015-0993-7 26242743 4526175
N.J. Witt D.W. Zochodne Bolton CF,Grand’Maison F, Wells G, Young GB, et al. Peripheral nerve function in sepsis and multiple organ failure. Chest. 1991 99 1 176 184 1:STN:280:DyaK3M%2FosFahtA%3D%3D 1845860
F. González-Seguel J.J. Pinto-Concha N. Aranis J. Leppe Adverse events of prone positioning in mechanically ventilated adults with ARDS Respir Care. 2021 66 12 1898 1911 10.4187/respcare.09194 34301802
K.P. Steinberg L.D. Hudson R.B. Goodman C.L. Hough P.N. Lanken R. Hyzy et al. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome N Engl J Med. 2006 354 16 1671 1684 1:CAS:528:DC%2BD28Xjs12gsL0%3D 10.1056/NEJMoa051693 16625008
M.A. de Letter P.I. Schmitz L.H. Visser VerheulFA,Schellens RL Op de Coul DA, et al. Risk factors for the development of polyneuropathy and myopathy in critically ill patients Crit Care Med. 2001 29 12 2281 2286 11801825
S. Nanas K. Kritikos E. Angelopoulos A. Siafaka S. Tsikriki M. Poriazi et al. Predisposing factors for critical illness polyneuromyopathy in a multidisciplinary intensive care unit Acta Neurol Scand 2008 118 3 175 181 1:STN:280:DC%2BD1cnhtlyltQ%3D%3D 10.1111/j.1600-0404.2008.00996.x 18355395
J. Garnacho-Montero J. Madrazo-Osuna J.L. García-Garmendia C. Ortiz-Leyba F.J. Jiménez-Jiménez A. Barrero-Almodóvar et al. Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients. Intensive Care Med 2001 27 8 1288 96 1:STN:280:DC%2BD3Mvms1Kgug%3D%3D 10.1007/s001340101009 11511941
M. van der Schaaf A. Beelen R. de Vos Functional outcome in patients with critical illness polyneuropathy Disabil Rehabil. 2004 26 20 1189 97 10.1080/09638280410001724861 15371019
