Of sedation, duration of ICU treatment and development of CIP was

Of sedation, duration of ICU treatment and development of CIP was found. Larger studies are needed to establish the determinants of CIP.P110 Neurally adjusted ventilatory assistance in patients with critical illness polyneuromyopathyD Tuchscherer1, W Z’Graggen1, A Brunello1, C Passath1, C Sinderby2, J Takala1, SM Jakob1, L Brander1 1University Hospital Bern, Switzerland; 2St Michael’s Hospital, Toronto, ON, Canada Critical Care 2009, 13(Suppl 1):P110 (doi: 10.1186/cc7274) Introduction Neurally adjusted ventilatory assistance (NAVA) delivers pressure (Paw) in proportion to the electrical activity of the diaphragm (EAdi). It is not known whether EAdi adequately reflects the respiratory drive in patients with critical illness polyneuromyopathy (CIPM) and would be sufficient to deliver assistance using NAVA. Methods Fifteen invasively ventilated patients (median (quartiles): 66 (59; 73) years old, APACHE II score 19 (17; 24)) with electrophysiologically documented CIPM were studied. A level of adequate unloading (NAVAAL) was identified daily based on the characteristic response in Paw and tidal volume (Vt) to stepwise increasing NAVA (titration) as previously described [1]. NAVAAL was used for a maximum of 72 hours. Results NAVAAL was implemented in 13 patients for 54 (40; 61) hours. Three 2′,3′-cGAMP patients were liberated from mechanical ventilation during the study. NAVA could not be used in two patients (diaphragm myoclonic; excessive respiratory drive). At NAVAAL peak inspiratory EAdi was reduced by 30 (25; 40) comparedP109 Determinants of critical illness polyneuropathy in the case of long-term ICU treatmentA Klimasauskas1, I Sereike1, G Kekstas1, A Klimasauskiene2, J Ivaskevicius1 1Vilnius University, Vilnius, Lithuania; 2Vilnius University Hospital, Vilnius, Lithuania Critical Care 2009, 13(Suppl 1):P109 (doi: 10.1186/cc7273) Introduction Neuromuscular weakness is a condition which is often found during long-term ICU treatment. Critical illness polyneuropathy (CIP) is the main reason for neuromuscular weakness.SAvailable online http://ccforum.com/supplements/13/STable 1 (abstract P110) PaO2/FiO2 NAVAAL day 1 NAVAAL day 3 227 PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/12083739 (158; 286) 263 (212; 380)* PaCO2 (mmHg) 36 (30; 45) 42 (39; 45)* Mean inspiratory EAdi (V) 5.6 (3.4; 7.8) 5.2 (2.9; 6.6) Vt (ml/kg predicted body weight) 6.7 (5.8; 8.3) 6.5 (5.4; 7.6) Respiratory rate (breaths/min) 30 (23; 34) 27 (22; 35)Data presented as median (quartiles). *P <0.05 vs. day 1.with the lowest NAVA level used during the titration. The breathing pattern, heart rate, and mean arterial pressure remained stable during NAVA. See Table 1. Conclusions EAdi was sufficient to use NAVA in most of our patients with moderate to severe CIPM. Implementation of a titrated NAVA level for up to 72 hours resulted in low Vt, improved oxygenation over time, and stable cardiorespiratory function. Acknowledgement Supported by the Swiss National Science Foundation 3200B0-113478/1. Reference 1. Brander L, et al.: Titration and implementation of neurally adjusted ventilatory assist in critically ill patients. Chest 2008 [Epub ahead of print].important cause of neuropathy in critical illness, it seems likely that muscle membrane depolarization may be an important cause of myopathy. Serum potassium is an important factor for muscle membrane depolarization in patients with renal failure. References 1. Z'Graggen WJ, et al.: Nerve excitability changes in critical illness polyneuropathy. Brain 2006, 129:2461-2470. 2. Z'Graggen WJ, et al.