Neuromyopathies secondaires en réanimation

Dussoix, Philippe; Chevrolet, Jean-Claude; Cox, Jeremiah N.; Pizzolato, Gianpaolo; Magistris, Michel R.

doi:10.1016/s1164-6756(05)80469-4

Cited by 8 publications

(1 citation statement)

References 44 publications

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“…Many factors107 have been incriminated in the pathogenesis of CIP: types of primary illness or injury,28, 194 immune mediation, Guillain–Barré syndrome,29 malnutrition and critical illness,28 antibiotics,181 neuromuscular blocking agents,71 nerve frailty due to premorbid conditions,9 hypoxia,58 hypotension,142 hyperpyrexia,179 iatrogenic mechanisms,29, 36, 124, 151, 181, 182 endotoxin,9, 182 tumor necrosis factor,124 and hyperosmolality and hyperglycemia 168, 171…”

Section: Pathophysiologymentioning

confidence: 99%

Neuromuscular manifestations of critical illness

Bolton¹

2005

Muscle and Nerve

364

253

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Critical illness, more precisely defined as the systemic inflammatory response syndrome (SIRS), occurs in 20%-50% of patients who have been on mechanical ventilation for more than 1 week in an intensive care unit. Critical illness polyneuropathy (CIP) and myopathy (CIM), singly or in combination, occur commonly in these patients and present as limb weakness and difficulty in weaning from the ventilator. Critical illness myopathy can be subdivided into thick-filament (myosin) loss, cachectic myopathy, acute rhabdomyolysis, and acute necrotizing myopathy of intensive care. SIRS is the predominant underlying factor in CIP and is likely a factor in CIM even though the effects of neuromuscular blocking agents and steroids predominate in CIM. Identification and characterization of the polyneuropathy and myopathy depend upon neurological examination, electrophysiological studies, measurement of serum creatine kinase, and, if features suggest a myopathy, muscle biopsy. The information is valuable in deciding treatment and prognosis.

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