Key result
ICU neuroleptic malignant syndrome carries a 10% mortality rate linked primarily to renal failure.
Why the study?
Neuroleptic malignant syndrome is a rare but life-threatening emergency, and the study aimed to update bedside procedures by investigating cases managed in the intensive care unit.
Cohort (n=20)
No
In a resource-limited Moroccan ICU setting, neuroleptic malignant syndrome was associated with a 10% mortality rate, primarily linked to renal failure, emphasizing the importance of early detection and supportive care.
Renal failure may link to NMS mortality in ICU; small cohort leaves open need for prospective validation.
Background: Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening neuropsychiatric emergency. The aim of our study was to update our bedside procedures by investigating NMS cases managed in the intensive care unit (ICU).Methods: This retrospective study included all NMS patients admitted to our hospital between January 2012 and December 2019. The variables analyzed included demographics, diagnosis, therapeutics, and outcomes.Results: This study included 20 patients, with an average age of 36.6 years. The male to female ratio was 1:4. No patient had a history of NMS, and 60% of the patients had schizophrenia. First-generation neuroleptics (NLs) were the most commonly prescribed drugs (80%). The mean time between the introduction of NLs and onset of symptoms was 7.6 days. Rigidity was observed in 90% of the patients, hyperthermia and neuropsychic syndrome in 65%, and dysautonomia in 50%. The creatine phosphokinase level in all patients was four times the normal value. Mechanical ventilation was required in 20% of the patients and hemodialysis in one patient. None of the patients received specific therapy. The mean duration of ICU stay was 10 days. The mortality rate was 10%,, mainly associated with renal failure. The analysis of the predictors of mortality was limited by the size of our cohort.Conclusion: NMS is a rare condition requiring multidisciplinary implementation of contextualized and updated procedures. Early detection and supportive treatment could improve the prognosis in resource-limited settings, where specific treatments are not available. Predictive risk factors should be investigated in larger multicenter cohorts.
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Touzani et al. (2021) conducted a cohort in Neuroleptic malignant syndrome (n=20). In a retrospective cohort of 20 intensive care unit patients with neuroleptic malignant syndrome, the mortality rate was 10%, which was mainly associated with renal failure.
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