- \(\bf Background:\) Diagnosis of intensive care unit acquired weakness (ICUAW) is challenging. Pathogenesis of underlying critical illness polyneuromyopathy (CIPNM) remains incompletely understood. This exploratory study investigated whether longitudinal neuromuscular ultrasound examinations and cytokine analyses in correlation to classical clinical and electrophysiological assessment contribute to the understanding of CIPNM.
\(\bf Methods:\) Intensive care unit patients were examined every 7 days until discharge from hospital. Clinical status, nerve conduction studies, electromyography as well as ultrasound of peripheral nerves and tibial anterior muscle were performed. Cytokine levels were analyzed by a bead-based multiplex assay system.
\(\bf Results:\) Of 248 screened patients, 35 patients were included at median of 6 days (IQR: 8) after admission to intensive care unit. Axonal damage was the main feature of CIPNM. At the peak of CIPNM (7 days after inclusion), nerve ultrasound showed cross-sectional area increase of tibial nerve as a sign of inflammatory edema as well as hypoechoic nerves as a possible sign of inflammation. Cytokine analyses showed signs of monocyte and macrophage activation at this stage. Fourteen days after inclusion, cytokines indicated systemic immune response as well as profiles associated to neovascularization and regeneration.
\(\bf Conclusions:\) Exploratory neuromuscular ultrasound and cytokine analyses showed signs of inflammation like macrophage and monocyte activation at the peak of CIPNM followed by a systemic immune response parallel to axonal damage. This underlines the role of both axonal damage and inflammation in pathogenesis of CIPNM.
MetadatenAuthor: | Anna Lena FisseORCiDGND, Caroline MayORCiDGND, Jeremias MotteORCiDGND, Xiomara PedreiturriaGND, Thomas Georg Karl BreuerGND, Christiane Schneider-GoldORCiDGND, Katrin Marcus-AlicORCiDGND, Ralf GoldORCiDGND, Min-Suk YoonGND, Kalliopi PitarokoiliORCiDGND |
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URN: | urn:nbn:de:hbz:294-95613 |
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DOI: | https://doi.org/10.1007/s12028-020-01148-2 |
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Parent Title (English): | Neurocritical care |
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Subtitle (English): | high-resolution neuromuscular ultrasound characteristics and cytokine profiling |
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Publisher: | Springer |
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Place of publication: | New York |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2023/01/05 |
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Date of first Publication: | 2020/11/24 |
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Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
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Tag: | Critical illness myopathy; Critical illness polyneuromyopathy; Critical illness polyneuropathy; Cytokines; Intensive care unit acquired weakness; Nerve ultrasound |
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Volume: | 35 |
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First Page: | 139 |
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Last Page: | 152 |
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Note: | Dieser Beitrag ist auf Grund des DEAL-Springer-Vertrages frei zugänglich. |
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Institutes/Facilities: | St. Josef-Hospital Bochum, Neurologische Klinik |
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Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
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open_access (DINI-Set): | open_access |
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Licence (English): | Creative Commons - CC BY 4.0 - Attribution 4.0 International |
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