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critical illness myopathy

David R Price, Mark E Mikkelsen, Craig A Umscheid, Ehrin J Armstrong
OBJECTIVE: The relationship between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness remains unclear. We examined the association between neuromuscular blocking agents and ICU-acquired weakness, critical illness polyneuropathy, and critical illness myopathy. DATA SOURCES: PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, and bibliographies of included studies were searched from database inception until September 24, 2015...
November 2016: Critical Care Medicine
Monica Llano-Diez, Arthur J Cheng, William Jonsson, Niklas Ivarsson, Håkan Westerblad, Vic Sun, Nicola Cacciani, Lars Larsson, Joseph Bruton
BACKGROUND: Critical illness myopathy is an acquired skeletal muscle disorder with severe myosin loss and muscle weakness frequently seen in intensive care unit (ICU) patients. It is unknown if impaired excitation-contraction coupling contributes to the muscle weakness. METHODS: We used a unique ICU model where rats were deeply sedated, post-synaptically pharmacologically paralyzed, mechanically ventilated and closely monitored for up to ten days. Single intact fibers from the flexor digitorum brevis muscle were isolated and used to measure force and free myoplasmic [Ca(2+)] ([Ca(2+)]i) during tetanic contractions...
August 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
Nicola Latronico
No abstract text is available yet for this article.
August 8, 2016: Intensive Care Medicine
Bronwen Connolly, Brenda O'Neill, Lisa Salisbury, Bronagh Blackwood
BACKGROUND: Physical rehabilitation interventions aim to ameliorate the effects of critical illness-associated muscle dysfunction in survivors. We conducted an overview of systematic reviews (SR) evaluating the effect of these interventions across the continuum of recovery. METHODS: Six electronic databases (Cochrane Library, CENTRAL, DARE, Medline, Embase, and Cinahl) were searched. Two review authors independently screened articles for eligibility and conducted data extraction and quality appraisal...
October 2016: Thorax
Sarah E Jolley, Aaron Bunnell, Catherine L Hough
Survivorship after critical illness is an increasingly important health care concern as intensive unit care (ICU) utilization continues to increase while ICU mortality is decreasing. Critical illness survivors experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay(1-7). Newfound impairment is associated with increased healthcare costs and utilization, reductions in health related quality of life and prolonged unemployment(5,8,9). Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in critically ill patients with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysunction(1,10,11)...
April 7, 2016: Chest
Margaret S Herridge, Marc Moss, Catherine L Hough, Ramona O Hopkins, Todd W Rice, O Joseph Bienvenu, Elie Azoulay
Outcomes after acute respiratory distress syndrome (ARDS) are similar to those of other survivors of critical illness and largely affect the nerve, muscle, and central nervous system but also include a constellation of varied physical devastations ranging from contractures and frozen joints to tooth loss and cosmesis. Compromised quality of life is related to a spectrum of impairment of physical, social, emotional, and neurocognitive function and to a much lesser extent discrete pulmonary disability. Intensive care unit-acquired weakness (ICUAW) is ubiquitous and includes contributions from both critical illness polyneuropathy and myopathy, and recovery from these lesions may be incomplete at 5 years after ICU discharge...
May 2016: Intensive Care Medicine
Rebeca Corpeno Kalamgi, Heba Salah, Stefano Gastaldello, Vicente Martinez-Redondo, Jorge L Ruas, Wen Fury, Yu Bai, Jesper Gromada, Roberta Sartori, Denis C Guttridge, Marco Sandri, Lars Larsson
KEY POINTS: Using an experimental rat intensive care unit (ICU) model, not limited by early mortality, we have previously shown that passive mechanical loading attenuates the loss of muscle mass and force-generation capacity associated with the ICU intervention. Mitochondrial dynamics have recently been shown to play a more important role in muscle atrophy than previously recognized. In this study we demonstrate that mitochondrial dynamics, as well as mitophagy, is affected by mechanosensing at the transcriptional level, and muscle changes induced by unloading are counteracted by passive mechanical loading...
August 1, 2016: Journal of Physiology
Rebeca C Kalamgi, Lars Larsson
The complete loss of mechanical stimuli of skeletal muscles, i.e., the loss of external strain, related to weight bearing, and internal strain, related to the contraction of muscle cells, is uniquely observed in pharmacologically paralyzed or deeply sedated mechanically ventilated intensive care unit (ICU) patients. The preferential loss of myosin and myosin associated proteins in limb and trunk muscles is a significant characteristic of critical illness myopathy (CIM) which separates CIM from other types of acquired muscle weaknesses in ICU patients...
2016: Frontiers in Physiology
R Kollmar
Intensive care unit acquired weakness (ICUAW) is a frequent and severe complication of intensive care management. Within ICUAW critical illness polyneuropathy (CIP) and myopathy (CIM) can be differentiated. The major symptom of ICUAW is progressive quadriparesis, which makes weaning from the respirator more difficult, can appear early after admission to an ICU and can often be detected several months after discharge from the ICU. The pathophysiology of ICUAW is multifactorial and complex. Potential therapeutic approaches are the early and sufficient therapy of mulitorgan dysfunction, optimal control of glucose levels as well as early and intensive physiotherapy...
March 2016: Der Nervenarzt
Cynthia Tsai, Mary Reed, Sarah Dayton, Joseph Smith
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Shauna Burkholder, Lee Burkholder, Matthew Prowse, Joe Watt, Ari Joffe
No abstract text is available yet for this article.
December 2015: Critical Care Medicine
Aida Field-Ridley, Madan Dharmar, David Steinhorn, Craig McDonald, James P Marcin
OBJECTIVE: ICU-acquired weakness, comprised critical illness myopathy and critical illness neuropathy, occurs in a significant proportion of critically ill adults and is associated with high morbidity and mortality. Little is known about ICU-acquired weakness among critically ill children. We investigated the incidence of ICU-acquired weakness among PICUs participating in the Virtual PICU Systems database. We also sought to identify associated risk factors for ICU-acquired weakness and evaluate the hypothesis that ICU-acquired weakness is associated with poor clinical outcomes...
January 2016: Pediatric Critical Care Medicine
Humberto Gonzalez Marrero, Erik V Stålberg
INTRODUCTION: In severe acute quadriplegic myopathy in intensive care unit (ICU) patients, muscle fibers are electrically inexcitable; in critical illness polyneuropathy, the excitability remains normal. Conventional electrodiagnostic methods do not provide the means to adequately differentiate between them. In this study we aimed to further optimize the methodology for the study of critically ill ICU patients and to create a reference database in healthy controls. METHODS: Different electrophysiologic protocols were tested to find sufficiently robust and reproducible techniques for clinical diagnostic applications...
April 2016: Muscle & Nerve
Luan Nguyen The, Cong Nguyen Huu
INTRODUCTION: Critical illness polyneuropathy, myopathy and polyneuromyopathy, grouped under the term CIP/CIM, share several risk factors and are associated with debilitating outcomes. OBJECTIVE: To assess the incidence and distribution of CIP/CIM subtypes and evaluate the risk factors and outcomes of CIP/CIM in a rural hospital in Vietnam. METHOD: One hundred and thirty three critically ill patients treated more than ten days in the ICU were enrolled...
October 15, 2015: Journal of the Neurological Sciences
Greet Hermans, Greet Van den Berghe
A substantial number of patients admitted to the ICU because of an acute illness, complicated surgery, severe trauma, or burn injury will develop a de novo form of muscle weakness during the ICU stay that is referred to as "intensive care unit acquired weakness" (ICUAW). This ICUAW evoked by critical illness can be due to axonal neuropathy, primary myopathy, or both. Underlying pathophysiological mechanisms comprise microvascular, electrical, metabolic, and bioenergetic alterations, interacting in a complex way and culminating in loss of muscle strength and/or muscle atrophy...
2015: Critical Care: the Official Journal of the Critical Care Forum
J Mehrholz, M Pohl, J Kugler, J Burridge, S Mückel, B Elsner
Intensive care unit (ICU) acquired or generalised weakness due to critical illness myopathy (CIM) and polyneuropathy (CIP) are major causes of chronically impaired motor function that can affect activities of daily living and quality of life. Physical rehabilitation of those affected might help to improve activities of daily living. Our primary objective was to assess the effects of physical rehabilitation therapies and interventions for people with CIP and CIM in improving activities of daily living such as walking, bathing, dressing and eating...
October 2015: European Journal of Physical and Rehabilitation Medicine
O Friedrich, M B Reid, G Van den Berghe, I Vanhorebeek, G Hermans, M M Rich, L Larsson
Critical illness polyneuropathies (CIP) and myopathies (CIM) are common complications of critical illness. Several weakness syndromes are summarized under the term intensive care unit-acquired weakness (ICUAW). We propose a classification of different ICUAW forms (CIM, CIP, sepsis-induced, steroid-denervation myopathy) and pathophysiological mechanisms from clinical and animal model data. Triggers include sepsis, mechanical ventilation, muscle unloading, steroid treatment, or denervation. Some ICUAW forms require stringent diagnostic features; CIM is marked by membrane hypoexcitability, severe atrophy, preferential myosin loss, ultrastructural alterations, and inadequate autophagy activation while myopathies in pure sepsis do not reproduce marked myosin loss...
July 2015: Physiological Reviews
Yamina Hamel, Asmaa Mamoune, François-Xavier Mauvais, Florence Habarou, Laetitia Lallement, Norma Beatriz Romero, Chris Ottolenghi, Pascale de Lonlay
Rhabdomyolysis results from the rapid breakdown of skeletal muscle fibers, which leads to leakage of potentially toxic cellular content into the systemic circulation. Acquired causes by direct injury to the sarcolemma are most frequent. The inherited causes are: i) metabolic with failure of energy production, including mitochondrial fatty acid ß-oxidation defects, LPIN1 mutations, inborn errors of glycogenolysis and glycolysis, more rarely mitochondrial respiratory chain deficiency, purine defects and peroxysomal α-methyl-acyl-CoA-racemase defect (AMACR), ii) structural causes with muscle dystrophies and myopathies, iii) calcium pump disorder with RYR1 gene mutations, iv) inflammatory causes with myositis...
July 2015: Journal of Inherited Metabolic Disease
Claire E Baldwin, Andrew D Bersten
PURPOSE OF REVIEW: Survivors of a critical illness may experience poor physical function and quality of life as a result of reduced skeletal muscle mass and strength during their acute illness. Patients diagnosed with sepsis are particularly at risk, and mechanical ventilation may result in diaphragm dysfunction. Interest in the interaction of these conditions is both growing and important to understand for individualized patient care. RECENT FINDINGS: This review describes developments in the presentation of both diaphragm and limb myopathy in critical illness, as measured from muscle biopsy and at the bedside with various imaging and strength-testing modalities...
May 2015: Current Opinion in Clinical Nutrition and Metabolic Care
Gloria-Beatrice Wintermann, Frank Martin Brunkhorst, Katja Petrowski, Bernhard Strauss, Frank Oehmichen, Marcus Pohl, Jenny Rosendahl
OBJECTIVES: To examine the frequency of acute stress disorder and posttraumatic stress disorder in chronically critically ill patients with a specific focus on severe sepsis, to classify different courses of stress disorders from 4 weeks to 6 months after transfer from acute care hospital to postacute rehabilitation, and to identify patients at risk by examining the relationship between clinical, demographic, and psychological variables and stress disorder symptoms. DESIGN: Prospective longitudinal cohort study, three assessment times within 4 weeks, 3 months, and 6 months after transfer to postacute rehabilitation...
June 2015: Critical Care Medicine
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