Critical illness polyneuromyopathy: Functional impact after severe acquired brain injuries

Bahia Hakiki, Francesca Draghi, Maenia Scarpino, Emilio Portaccio, Annamaria Romoli, Andrea Mannini, Tiziana Atzori, Francesco Lolli, Claudio Macchi, Antonello Grippo

Research output: Contribution to journalArticle

Abstract

Objectives: Critical illness polyneuropathy and myopathy (CIPNM) frequently affects critical patients and can occur after severe acquired brain injuries (sABI) influencing the functional recovery. We aimed to assess how the concomitance between CIPNM and sABI might influence the rehabilitative outcomes in terms of functional autonomy, oral feeding recovery and endotracheal tube weaning. Materials and Methods: Adult patients with sABI admitted to an intensive rehabilitation unit and underwent an electromyography examination within seven days after admission were included. Assessed rehabilitative outcomes at discharge were decannulation success and its timing, functional autonomy measured by the Functional Independence Measure (FIM) and the Glasgow outcome scale expanded (GOS-E) and oral feeding recovery assessed by the Functional Oral Intake Scale (FOIS) score. Results: Among the 224 included patients (81 (36%) females, age (median[IQR]): 68.73[21.66] years), 119 (53.1%) presented CIPNM at admission. Albeit the change of rehabilitative outcomes between admission and discharge was significant in all the sABI patients (P <.001 for ΔFOIS, ΔFIM and ΔGOS-E), those with a concomitant CIPNM achieved significantly lower scores as evaluated by Mann-Whitney tests (P <.001 for ΔFIM Δ and GOS-E; P <.005 for ΔFOIS). The CIPNM absence was associated with a higher probability to achieve functional autonomy (GOS-E > 4) (OR:4.57 (1.49/14.06); P <.01) and oral feeding recovery (FOIS ≥ 4) (OR:2.07 (1.07/3.99); P =.03) at discharge. CIPNM presence did not influence decannulation success but a longer time to cannula weaning was required (P <.01 in the log-rank test). Conclusions: CIPMN significantly affects the rehabilitative outcomes after a sABI and should be taken into account for better rehabilitative handling.

Original languageEnglish
JournalActa Neurologica Scandinavica
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • critical illness polyneuropathy and myopathy
  • decannulation
  • functional outcome
  • oral feeding
  • rehabilitation
  • severe acquired brain injury

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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