Patologia neuromuscular del paciente critico en pediatria

Objective. To describe and provide diagnosis guidelines for the neuromuscular pathology of the pediatric critical patients, manifested as extubation difficulty, based in our experience. Clinical cases. A retrospective study has been performed on three patients in the Pediatric Intensive Care Unit that were diagnosed by using clinical, analytical and electromyographical findings. In the three patients the presence of the disorder was suspected due to the extubation difficulty and the hypotony. All them received vecuronium as neuromuscular blockage while dexamethasone was provided to one of them due to a nodal tachycardia. Myopathic causes were discarded in view of the normally of the muscular enzymes. The electromyography showed an axonal disorder in all three child. Neither lumbar puncture nor muscular biopsy were performed in any of them. Conclusions. The three patients were diagnosed for a drug neuropathy (neuromuscular blocked and/or corticotherapy). There were described another causes of the critical patient polyneuropathy in the literature, but we didn't find any of them.