Is plasma calcium concentration implicated in the development of critical illness polyneuropathy and myopathy?

Crit Care. 2011;15(5):R247. doi: 10.1186/cc10505. Epub 2011 Oct 21.

Abstract

Introduction: This prospective study investigated whether plasma ionized calcium concentration abnormalities and other electrolyte disturbances represent risk factors for the development of critical illness polyneuromyopathy (CIPNM) in ICU patients.

Methods: One hundred and ninety consecutive adult critically ill patients with prolonged ICU stay (longer than 7 days) were prospectively evaluated. Patients with acute weakness and/or weaning difficulties were subjected to extensive electrophysiological measurements in order to establish the diagnosis of CIPNM. All recognized and/or possible risk factors for development of CIPNM were recorded.

Results: The diagnosis of CIPNM was confirmed in 40 patients (21.05%). By applying a logistic regression model, hypocalcemia (P = 0.02), hypercalcemia (P = 0.01) and septic shock (P = 0.04) were independently associated with the development of CIPNM in critically ill patients.

Conclusions: We found that septic shock and abnormal fluctuations of plasma Ca²⁺ concentration represent significant risk factors for the development of CIPNM in critically ill patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Calcium / blood*
  • Calcium Metabolism Disorders / complications*
  • Critical Illness
  • Female
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Muscular Diseases / blood
  • Muscular Diseases / etiology*
  • Polyneuropathies / blood
  • Polyneuropathies / etiology*
  • Prospective Studies
  • Risk Factors
  • Water-Electrolyte Balance

Substances

  • Biomarkers
  • Calcium