Myopathic characteristics in septic mechanically ventilated patients

Current Opinion in Clinical Nutrition and Metabolic Care
Claire E Baldwin, Andrew D Bersten

Abstract

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. 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. The influence of unloading of the diaphragm with mechanical ventilation and peripheral muscles with immobilization in septic patients has been recently questioned. Systemic inflammation appears to primarily accelerate and accentuate dysfunction, which may be remedied by early mobilization and augmented with developing muscle and/or nerve stimulation techniques. Many acute muscle changes in septic patients are likely to stem from pre-existing impairments, which should provide context for clinical evaluations of strength. During illness, sarcolemmal injury promotes a cascade of intra-cellular abnormalitie...Continue Reading

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Citations

Jun 22, 2016·Journal of the American Medical Directors Association·Josep M ArgilésLeocadio Rodriguez-Mañas

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Methods Mentioned

BETA
biopsies
biopsy

Clinical Trials Mentioned

NCT01206166

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