Screening for critical illness polyneuromyopathy with single nerve conduction studies

Moss, Marc; Yang, Michele; Macht, Madison; Sottile, Peter D.; Gray, Laura; McNulty, Monica; Quan, Dianna

doi:10.1007/s00134-014-3251-6

Cited by 61 publications

(62 citation statements)

References 35 publications

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“…Furthermore, objective neuromuscular changes may be more prevalent than is clinically measurable weakness, and studies suggest that these neuromuscular changes may impact outcomes adversely. 7,8 Among 730 patients with respiratory failure, the presence of an abnormal CMAP on day 8 of ventilation was associated with a 20.4% higher 1-year mortality, with a significant difference in the absence of demonstrable weakness (MRC > 48; 1-year mortality, 48.2% [group with abnormal CMAP] vs 29.3%; P ¼ .010). 7 Therefore, the impact of these occult neuromuscular changes on longer-term function and outcomes may be greater than previously understood.…”

Section: Epidemiology Of Icu-acquired Weaknessmentioning

confidence: 99%

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ICU-Acquired Weakness

Jolley

Bunnell

Hough

2016

Chest

278

229

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Survivorship after critical illness is an increasingly important health-care concern as ICU use continues to increase while ICU mortality is decreasing. Survivors of critical illness experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay. Newfound impairment is associated with increased health-care costs and use, reductions in health-related quality of life, and prolonged unemployment. Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in patients who are critically ill, with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysfunction. ICU-acquired weakness (ICUAW) is associated with longer durations of mechanical ventilation and hospitalization, along with greater functional impairment for survivors. Although there is increasing recognition of ICUAW as a clinical entity, significant knowledge gaps exist concerning identifying patients at high risk for its development and understanding its role in long-term outcomes after critical illness. This review addresses the epidemiologic and pathophysiologic aspects of ICUAW; highlights the diagnostic challenges associated with its diagnosis in patients who are critically ill; and proposes, to our knowledge, a novel strategy for identifying ICUAW.

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Section: Epidemiology Of Icu-acquired Weaknessmentioning

confidence: 99%

“…8 This test is quick, safe, and easy to administer. The common peroneal (fibular) CMAP is measured using two surface electrodes, with the active electrode placed on the belly of the extensor digitorum brevis muscle and the reference electrode placed on the distal tendon of the recorded muscle (Fig 1).…”

Section: Additional Diagnostic Approaches To Identify Icuawmentioning

confidence: 99%

ICU-Acquired Weakness

Jolley

Bunnell

Hough

2016

Chest

278

229

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“…This is important because CIM has a better prognosis than CIP at both short-term [7] and long-term follow-up [8]. An article in this issue of Intensive Care Medicine by Moss and colleagues [9] highlights the importance of the accurate diagnosis of neuromuscular weakness. In this study, patients with abnormal EPS had significantly increased mortality (50 %) compared to those with normal EPS findings (13 %).…”

mentioning

confidence: 99%

Introducing simplified electrophysiological test of peripheral nerves and muscles in the ICU: choosing wisely

Latronico

Smith

2014

Intensive Care Med

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“…Although CIP and CIM, which are considered to be major causes of muscle weakness in sepsis, can be found independently from each other, they are mostly seen together; this picture is termed CIPNM (1,6,22,23).…”

Section: Discussionmentioning

confidence: 99%

Neuromuscular Dysfunction in Experimental Sepsis and Glutamine

et al. 2016

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Background: Electrophysiological studies show that critical illness polyneuromyopathy appears in the early stage of sepsis before the manifestation of clinical findings. The metabolic response observed during sepsis causes glutamine to become a relative essential amino acid. Aims: We aimed to assess the changes in neuromuscular transmission in the early stage of sepsis after glutamine supplementation. Study Design: Animal experimentation. Methods: Twenty male Sprague-Dawley rats were randomized into two groups. Rats in both groups were given normal feeding for one week. In the study group, 1 g/kg/day glutamine was added to normal feeding by feeding tube for one week. Cecal ligation and perforation (CLP) surgery was performed at the end of one week. Before and 24 hours after CLP, compound muscle action potentials were recorded from the gastrocnemius muscle. Results: Latency measurements before and 24 hours after CLP were 0.68±0.05 ms and 0.80±0.09 ms in the control group and 0.69±0.07 ms and 0.73±0.07 ms in the study group (p<0.05). Conclusion: Since enteral glutamine prevented compound muscle action potentials (CMAP) latency prolongation in the early phase of sepsis, it was concluded that enteral glutamine replacement might be promising in the prevention of neuromuscular dysfunction in sepsis; however, further studies are required.

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Screening for critical illness polyneuromyopathy with single nerve conduction studies

Cited by 61 publications

References 35 publications

ICU-Acquired Weakness

ICU-Acquired Weakness

Introducing simplified electrophysiological test of peripheral nerves and muscles in the ICU: choosing wisely

Neuromuscular Dysfunction in Experimental Sepsis and Glutamine

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