risk factors in critical illness myopathy during the early course of critical illness a prospective observational study关键风险因素疾病早期,肌病的重要疾病前瞻性观察性研究.pdfVIP

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risk factors in critical illness myopathy during the early course of critical illness a prospective observational study关键风险因素疾病早期,肌病的重要疾病前瞻性观察性研究.pdf

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risk factors in critical illness myopathy during the early course of critical illness a prospective observational study关键风险因素疾病早期,肌病的重要疾病前瞻性观察性研究

Weber-Carstens et al. Critical Care 2010, 14:R119 /content/14/3/R119 R E S E A R C H Open Access Research Risk factors in critical illness myopathy during the early course of critical illness: a prospective observational study †1,2 †1,2 1,2 3 1,2 4 Steffen Weber-Carstens* , Maria Deja , Susanne Koch , Joachim Spranger , Florian Bubser , Klaus D Wernecke , 1,2 5 1,2 Claudia D Spies , Simone Spuler and Didier Keh Abstract Introduction: Non-excitable muscle membrane indicates critical illness myopathy (CIM) during early critical illness. We investigated predisposing risk factors for non-excitable muscle membrane at onset of critical illness. Methods: We performed sequential measurements of muscle membrane excitability after direct muscle stimulation (dmCMAP) in 40 intensive care unit (ICU) patients selected upon a simplified acute physiology (SAPS-II) score ≥ 20 on 3 successive days within 1 week after ICU admission. We then investigated predisposing risk factors, including the insulin-like growth factor (IGF)-system, inflammatory, metabolic and hemodynamic parameters, as well as suspected medical treatment prior to first occurrence of abnormal dmCMAP. Nonparametric analysis of two-factorial longitudinal data and multivariate analysis were used for statistical analysis. Results: 22 patients showed abnormal muscle membrane excitability during direct muscle stimulation within 7 (5 to 9.25) days after ICU admission. Significant risk factors for the development of impaired muscle membrane excitability in univariate analysis included inflammation, disease severity, catecholamine and sedati