Tankisi, A; Pedersen, T H; Bostock, H; Z'Graggen, W.J.; Larsen, L H; Meldgaard, M; Elkmann, T; Tankisi, H (2021). Early detection of evolving critical illness myopathy with muscle velocity recovery cycles. Clinical neurophysiology, 132(6), pp. 1347-1357. Elsevier 10.1016/j.clinph.2021.01.017
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OBJECTIVE
To investigate the sensitivity of muscle velocity recovery cycles (MVRCs) for detecting altered membrane properties in critically ill patients, and to compare this to conventional nerve conduction studies (NCS) and quantitative electromyography (qEMG).
METHODS
Twenty-four patients with intensive care unit acquired weakness (ICUAW) and 34 healthy subjects were prospectively recruited. In addition to NCS (median, ulnar, peroneal, tibial and sural nerves) and qEMG (biceps brachii, vastus medialis and anterior tibial muscles), MVRCs with frequency ramp were recorded from anterior tibial muscle.
RESULTS
MVRC and frequency ramp parameters showed abnormal muscle fiber membrane properties with up to 100% sensitivity and specificity. qEMG showed myopathy in 15 patients (63%) while polyneuropathy was seen in 3 (13%). Decreased compound muscle action potential (CMAP) amplitude (up to 58%) and absent F-waves (up to 75%) were frequent, but long duration CMAPs were only seen in one patient with severe myopathy.
CONCLUSIONS
Altered muscle fiber membrane properties can be detected in patients with ICUAW not yet fulfilling diagnostic criteria for critical illness myopathy (CIM). MVRCs may therefore serve as a tool for early detection of evolving CIM.
SIGNIFICANCE
CIM is often under-recognized by intensivists, and large-scale longitudinal studies are needed to determine its incidence and pathogenesis.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery 04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Z'Graggen, Werner Josef |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1388-2457 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Chantal Kottler |
Date Deposited: |
06 Jul 2021 17:39 |
Last Modified: |
05 Dec 2022 15:51 |
Publisher DOI: |
10.1016/j.clinph.2021.01.017 |
PubMed ID: |
33676846 |
Uncontrolled Keywords: |
Critical illness myopathy Critical illness polyneuropathy Electromyography Intensive care unit acquired weakness Muscle velocity recovery cycles Nerve conduction studies |
BORIS DOI: |
10.48350/157367 |
URI: |
https://boris.unibe.ch/id/eprint/157367 |
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