To study the effect of treatment of anaemia with recombinant human erythropoietin (r-HUEPO) on neuromuscular function in patients undergoing haemodialysis for chronic renal failure, six patients were given r-HUEPO in an initial dose of 50 u/kg three times a week and their haemoglobin concentration was measured. The dose was increased by 25 u/kg every four weeks if the response was not satisfactory. In five patients anaemia had been corrected within 12 weeks of initiation of treatment. Neuromuscular function was evaluated before treatment, half way through, and after correction of anaemia by clinical examination and neurophysiological studies including motor nerve conduction velocity, distal latency, electromyography and test for neuromuscular fatigue. After correction of anaemia there was a significant increase in motor nerve conduction velocity, a decrease in the duration of motor unit action potential, and a lessening of neuromuscular fatigue. We conclude that treatment of anaemia with r-HUEPO in patients with chronic renal failure undergoing haemodialysis may improve neuromuscular function.
Neuromuscular status of amyloid and control groups of kidney transplant recipients was assessed through complete neurological examination, assay for serum levels of muscle enzymes (CPK and LDH), electromyography and nerve conduction velocity studies. Neuromyopathic findings were detected in both groups but without severe disabling clinical manifestations. These findings were more prominent in the amyloid group, evidenced by a more significant increase in polyphasicity detected by electromyography and longer prolongation of terminal latency measured in the median nerve. From this study, we concluded that amyloid kidney transplant recipients are more prone to neuromyopathy than the general kidney transplant population, which is mostly due to the amyloidosis itself and/or the colchicine therapy.
Background: Several studies have established a link between fluid overload and an increased risk of death. After cardiac surgery, patients' fluid status should be assessed at close intervals. A daily fluid balance (FB) has several limitations. This study aims to determine the agreement and correlation between fluid status changes calculated by the daily fluid balance through the conventional charting approach and body weight (BW) change using beds equipped with weighing scales. Methods: This is a prospective observational study that included 50 patients who underwent cardiac surgeries. It evaluates the precision and usefulness of determining body fluid status and requirements using daily fluid balance and body weight measurements. Results: The mean age of the study group was 52.9 ±10.44 years. The mean weight, height, and BMI were 87.1 ± 16.68 Kg, 170.4 ± 4.59 cm, and 30.12 ± 6.21 kg/m2. The mean duration of mechanical ventilation was 9.5 ±3.73 h. Mean ICU and hospitalization times were 2.4 ± 0.67 and 6.3 ± 1.36 days, respectively. The mean cumulative fluid balance was 0.52 ± 3.21 L, and the overall change in body weight (discharge weight − admission weight) was 0.55 ± 2.89 kg. There was a highly significant positive correlation between overall bodyweight and cumulative fluid balance (r- coefficeient= 0.947, p-value <0.001). Conclusion: Bodyweight measured by weight-enabled beds could seem sufficiently robust or accurate to replace daily FB in ICU post open heart. Such measurement might be used to monitor overall changes in BW in patients with a prolonged ICU stay.
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