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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
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
Cynthia Tsai, Mary Reed, Sarah Dayton, Joseph Smith
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
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
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
Benjamin T Barnes, Amy L Confides, Mark M Rich, Esther E Dupont-Versteegden
Critical illness myopathy (CIM) is associated with severe muscle atrophy and fatigue in affected patients. Apoptotic signaling is involved in atrophy and is elevated in muscles from patients with CIM. In this study we investigated underlying mechanisms of apoptosis-related pathways in muscles with different fiber type composition in a rat model of CIM using denervation and glucocorticoid administration (denervation and steroid-induced myopathy, DSIM). Soleus and tibialis anterior (TA) muscles showed severe muscle atrophy (40-60% of control muscle weight) and significant apoptosis in interstitial as well as myofiber nuclei that was similar between the two muscles with DSIM...
June 2015: Journal of Muscle Research and Cell Motility
Jan Mehrholz, Simone Mückel, Frank Oehmichen, Marcus Pohl
INTRODUCTION: Critical illness myopathy (CIM) and polyneuropathy (CIP) are common complications of critical illness that frequently occur together. Both cause so called intensive care unit (ICU)-acquired muscle weakness. This weakness of limb muscles increases morbidity and delay rehabilitation and recovery of walking ability. Although full recovery has been reported people with severe weakness may take months to improve walking. Focused physical rehabilitation of people with ICU-acquired muscle weakness is therefore of great importance...
2014: BMJ Open
H Axer, J Rosendahl, F M Brunkhorst
BACKGROUND: In addition to the limitations to the health-related quality of life that have been compiled with validated test instruments, a number of former sepsis patients suffer from functional impairments, which are categorized under the terms critical illness polyneuropathy (CIP) or critical illness myopathy (CIM), which have been in existence for over 20 years now. CURRENT FOCUS: The issues of delirium during intensive therapy and persistent residual neurocognitive impairments, posttraumatic stress disorder (PTSD) and states of depression related to perihospital functional development have increasingly attracted notice...
November 2014: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Jules Osias, Edward Manno
Neuromuscular sequelae are common in the critically ill. Critical illness polyneuropathy and critical illness myopathy are neuromuscular complications of sepsis or iatrogenic complications of treatments required in intensive care. This article discusses the diagnosis, treatment, and prognosis of these disorders based on a literature review. This review found that glycemic control, early mobilization, and judicious use of steroids and neuromuscular blocking agents are the primary approaches to reduce the incidence and severity of neuromuscular complications in affected patients...
October 2014: Critical Care Clinics
Chunkui Zhou, Limin Wu, Fengming Ni, Wei Ji, Jiang Wu, Hongliang Zhang
Critical illness polyneuropathy and critical illness myopathy are frequent complications of severe illness that involve sensorimotor axons and skeletal muscles, respectively. Clinically, they manifest as limb and respiratory muscle weakness. Critical illness polyneuropathy/myopathy in isolation or combination increases intensive care unit morbidity via the inability or difficulty in weaning these patients off mechanical ventilation. Many patients continue to suffer from decreased exercise capacity and compromised quality of life for months to years after the acute event...
January 1, 2014: Neural Regeneration Research
Karin A Ackermann, Hugh Bostock, Lukas Brander, Ralph Schröder, Siamak Djafarzadeh, Daniel Tuchscherer, Stephan M Jakob, Jukka Takala, Werner J Z'Graggen
INTRODUCTION: Sepsis-induced myopathy and critical illness myopathy (CIM) are possible causes of muscle weakness in intensive care patients. They have been attributed to muscle membrane dysfunction. The aim of this study was to investigate membrane properties in the early stage of experimental sepsis by evaluating muscle excitability. METHODS: In total, 20 anesthetized and mechanically ventilated pigs were randomized to either faecal peritonitis (n = 10) or to non-septic controls (n = 10)...
2014: Critical Care: the Official Journal of the Critical Care Forum
Efstratios Apostolakis, Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, George Papadopoulos
Thirty to fifty percent of critically ill patients admitted to the intensive care unit suffer from generalized neuromuscular weakness due to critical illness polyneuropathy, critical illness myopathy, or a combination of them, thus prolonging mechanical ventilation and their intensive care unit stay. A distinction between these syndromes and other neuromuscular abnormalities beginning either before or after ICU admission is necessary. These intensive care unit-related diseases are associated with both elevated mortality rates and increased morbidity rates...
February 2015: Journal of Anesthesia
Hannah Ogilvie, Lars Larsson
The muscle wasting and loss of specific force associated with Critical Illness Myopathy (CIM) is, at least in part, due to a preferential loss of the molecular motor protein myosin. This acquired myopathy is common in critically ill immobilized and mechanically ventilated intensive care patients (ICU). There is a growing understanding of the mechanisms underlying CIM, but the role of nutritional factors triggering this serious complication of modern intensive care remains unknown. This study aims at establishing the effect of nutritional status in the pathogenesis of CIM...
2014: Biology
Hazem Akkad, Rebeca Corpeno, Lars Larsson
Critical illness myopathy (CIM) is a debilitating common consequence of modern intensive care, characterized by severe muscle wasting, weakness and a decreased myosin/actin (M/A) ratio. Limb/trunk muscles are primarily affected by this myopathy while cranial nerve innervated muscles are spared or less affected, but the mechanisms underlying these muscle-specific differences remain unknown. In this time-resolved study, the cranial nerve innervated masseter muscle was studied in a unique experimental rat intensive care unit (ICU) model, where animals were exposed to sedation, neuromuscular blockade (NMB), mechanical ventilation, and immobilization for durations varying between 6 h and 14d...
2014: PloS One
Vinay Kukreti, Mosharraf Shamim, Praveen Khilnani
BACKGROUND AND AIMS: Intensive care unit acquired weakness (ICUAW) is a common occurrence in patients who are critically ill. It is most often due to critical illness polyneuropathy (CIP) or to critical illness myopathy (CIM). ICUAW is increasingly being recognized partly as a consequence of improved survival in patients with severe sepsis and multi-organ failure, partly related to commonly used agents such as steroids and muscle relaxants. There have been occasional reports of CIP and CIM in children, but little is known about their prevalence or clinical impact in the pediatric population...
February 2014: Indian Journal of Critical Care Medicine
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