1h-MNM can record simultaneously VEEG/aEEG/SEP-C in newborn infants, showing the modulation of SEP cortical responses in relation to behavioural states in all infants studied using an appropriate neonatal method. We emphasize the importance of obtaining neonatal SEP-C normative data to better identify pathological findings in neonatal brain injury.
Our MUS study provides new data on physiological muscle structural changes in healthy children to address the limited available references in this age group. Muscle Nerve 58: 245-250, 2018.
The sensory-motor conduction parameters were clearly related to gestational age, but extrauterine life did not affect the maturation of the peripheral nervous system in the very preterm babies who were neurologically healthy.
Neonatal encephalopathy is a significant cause of infant mortality and morbidity with risk of neurological sequelae in the survivors of neonates admitted to Neonatal (N) Intensive Care Unit (ICU). The EEG and Evoked Potentials (EPs) are very informative in the ICU. In particular, it is known that the SomatoSensory (SS) EPs are the best single indicator of early prognosis in adults and children patients with traumatic and/or hypoxic-ischemic coma compared to the Glasgow Coma Scale (GCS) and CTscan. Most paediatric studies excluded newborns in an attempt to eliminate the age effects, because of the structural and functional immaturity of somatosensory system. In fact, newborns differ from adults and paediatric patients for many aspects: hypoxic-ischemic aetiology, SSEPs normative data, grading and predictive values, timing and techniques recording, clinical scales of evaluation. Recently a diagnostic and predictive role of early SSEPs has been established in perinatal hypoxic-ischemic. We reported a literature review of early diagnostic/prognostic role of SSEPs and our preliminary neurophysiological data of prospective study in mild or severe perinatal hypoxic-ischemic insult.
Background
Critical illness polyneuropathy and myopathy (CIPNM) is a frequent neurological manifestation in patients with acute respiratory distress syndrome (ARDS) from coronavirus disease 2019 (COVID‐19) infection. CIPNM diagnosis is usually limited to clinical evaluation. We compared patients with ARDS from COVID‐19 and other aetiologies, in whom a neurophysiological evaluation for the detection of CIPNM was performed. The aim was to determine if there were any differences between these two groups in frequency of CINPM and outcome at discharge from the intensive care unit (ICU).
Materials and Methods
This was a single‐centre retrospective study performed on mechanically ventilated patients consecutively admitted (January 2016‐June 2020) to the ICU of Careggi Hospital, Florence, Italy, with ARDS of different aetiologies. Neurophysiological evaluation was performed on patients with stable ventilation parameters, but marked widespread hyposthenia (Medical Research Council score <48). Creatine phosphokinase (CPK), lactic dehydrogenase (LDH) and mean morning glycaemic values were collected.
Results
From a total of 148 patients, 23 with COVID‐19 infection and 21 with ARDS due to other aetiologies, underwent electroneurography/electromyography (ENG/EMG) recording. Incidence of CIPNM was similar in the two groups, 65% (15 of 23) in COVID‐19 patients and 71% (15 of 21) in patients affected by ARDS of other aetiologies. At ICU discharge, subjects with CIPNM more frequently required ventilatory support, regardless the aetiology of ARDS.
Conclusion
ENG/EMG represents a useful tool in the identification of the neuromuscular causes underlying ventilator wean failure and patient stratification. A high incidence of CIPNM, with a similar percentage, has been observed in ARDS patients of all aetiologies.
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