Steroid-Induced Myopathy in the ICU

Polsonetti, Bryan W; Joy, Saju; Laos, Luis F.

doi:10.1345/aph.1c095

Cited by 25 publications

(4 citation statements)

References 12 publications

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“…The correlation between steroid treatment and dyspnoea scale and some respiratory functional values appear to be independent from pneumonia severity and could reflect the contribute of steroid to viral myopathy through several mechanisms, such as altered electrical excitability of muscle fibres, loss of thick filaments and inhibition of protein synthesis [18][19][20], even if MIP and MEP didn't prove this relation.…”

Section: Discussionmentioning

confidence: 99%

Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life

et al. 2021

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BackgroundCoronavirus disease 2019 (COVID-19) has spread worldwide determining a dramatic impact on the healthcare system. Aim of this study is to evaluate mid-term clinical impact of COVID-19 on respiratory function.Methods379 patients were evaluated 4 months after SARS-COV-2 diagnosis. Patients were divided in two groups based on the presence of pneumonia during COVID. Clinical conditions, quality of life, symptomatology, 6-min walking test, pulmonary function test with spirometry and diffusing capacity of carbon monoxide were analysed. Data were compared to clinical evolution during COVID (development of acute respiratory distress syndrome [ARDS], needing of invasive mechanical ventilation [IMV], partial oxygen saturation/ fraction of inspired oxygen [SpO2/FiO2] ratio and pneumonia severity index [PSI]).ResultsAfter a median of 135 days, 260 (68.6%) of 379 patients referred almost one symptom. Patients who developed pneumonia during COVID-19 showed lower SpO2 at rest (p<0.001), SpO2 during 6-min walking test (p<0.001), total lung capacity (p<0.001), airway occlusion pressure after 0.1 s [P0.1] (p=0.02), P0.1/maximal inspiratory pressure [MIP] ratio (p=0.005) and higher Borg category-ratio scale (p=0.006) and modified Medical Research Council breathlessness scale (p=0.003), compared to patients without pneumonia. SpO2/FiO2 ratio and PSI during SARS-COV-2 pneumonia were directly associated with mid-term alteration of partial oxygen saturation at rest (p<0.001), SpO2 during 6-min walking test (p<0.001), residual volume (p<0.001), total lung capacity (respectively p<0.001 and p=0.003) and forced vital capacity (respectively p=0.004, p=0.03).ConclusionLung damage during COVID-19 correlates to the reduction of pulmonary function after 4 months from acute infection.

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Section: Discussionmentioning

confidence: 99%

Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life

et al. 2021

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“…11,[18][19][20] Biopsies of skeletal muscle showed variation in muscle fibre size, atrophy, and necrosis. 11,21 One study 22 on steroidinduced myopathy in rabbits showed changes as early as 4 h after cortisone injections to one lower extremity.…”

Section: Discussionmentioning

confidence: 99%

Steroid-induced ptosis: case studies and histopathologic analysis

Song

Carter

Nerad

et al. 2007

Eye

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Purpose The purpose of this study was to review patients who developed ptosis after subtenon's steroid injection and to study the mechanism of steroid-induced ptosis in an animal model. Methods Part 1. Twenty-two patients with uveitis who had received posterior subtenon's triamcinolone acetonide injections were retrospectively reviewed. Demographics, type of uveitis, type and number of surgeries, pre and postoperative marginal reflex distance (MRD1), and clinical outcomes were evaluated. Part 2. Study of rabbit levator muscle and aponeurosis histopathology after subtenon's triamcinolone injection was performed. Results Part 1. The average age was 44.6 years (range: 14 -85

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“…However, use of neuromuscular blockers should be discontinued as soon as feasible to reduce the likelihood of prolonged muscle weakness from the interaction of these agents and corticosteroids. ( 76 , 77 ) We prefer to use cisatracurium because it does not contain the corticosteroid-like moiety found in vecuronium and rocuronium that is thought to explain the association between myopathy and co-therapy with both corticosteroids and aminosteroid-based neuromuscular antagonists. ( 76 , 77 )…”

Section: Intubation Analgesia Sedation and Muscle Relaxationmentioning

confidence: 99%

Tratamento atual de crianças com asma crítica e quase fatal

Shein¹,

Speicher²,

Filho³

et al. 2016

Revista Brasileira De Terapia Intensiva

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Asthma is the most common chronic illness in childhood. Although the vast majority of children with acute asthma exacerbations do not require critical care, some fail to respond to standard treatment and require escalation of support. Children with critical or near-fatal asthma require close monitoring for deterioration and may require aggressive treatment strategies. This review examines the available evidence supporting therapies for critical and near-fatal asthma and summarizes the contemporary clinical care of these children. Typical treatment includes parenteral corticosteroids and inhaled or intravenous beta-agonist drugs. For children with an inadequate response to standard therapy, inhaled ipratropium bromide, intravenous magnesium sulfate, methylxanthines, helium-oxygen mixtures, and non-invasive mechanical support can be used. Patients with progressive respiratory failure benefit from mechanical ventilation with a strategy that employs large tidal volumes and low ventilator rates to minimize dynamic hyperinflation, barotrauma, and hypotension. Sedatives, analgesics and a neuromuscular blocker are often necessary in the early phase of treatment to facilitate a state of controlled hypoventilation and permissive hypercapnia. Patients who fail to improve with mechanical ventilation may be considered for less common approaches, such as inhaled anesthetics, bronchoscopy, and extracorporeal life support. This contemporary approach has resulted in extremely low mortality rates, even in children requiring mechanical support.

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Steroid-Induced Myopathy in the ICU

Cited by 25 publications

References 12 publications

Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life

Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life

Steroid-induced ptosis: case studies and histopathologic analysis

Tratamento atual de crianças com asma crítica e quase fatal

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