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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Risk factors in critical illness myopathy during the early course of critical illness: a prospective observational study. | Weber-Carstens et al. Critical Care 2010 14 R119 http ccforum.eom content 14 3 R119 c CRITICAL CARE RESEARCH Open Access Risklfactors in critical illness myopathy during the early course of critical illness a prospective observational study Steffen Weber-Carstens 41 2 Maria Deja41 2 Susanne Koch 1 2 Joachim Spranger3 Florian Bubser1 2 Klaus D Wernecke4 Claudia D Spies1 2 Simone Spuler5 and Didier Keh1 2 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 sedation requirements as well as IGF binding protein-1 IGFBP-I but did not include either adjunctive hydrocortisone treatment in septic shock nor administration of neuromuscular blocking agents or aminoglycosides. In multivariate Cox regression analysis interleukin-6 remained the significant risk factor for the development of impaired muscle membrane excitability HR 1.006 95 -CI 1.002 to 1.011 P 0.002 . Conclusions Systemic
