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Early development of critical illness myopathy and neuropathy in patients with severe sepsis.
Neurology. 2006 Oct 24; 67(8):1421-5.Neur

Abstract

OBJECTIVES

To characterize the prevalence, time of onset, and cause of neuromuscular dysfunction in patients with severe sepsis.

METHODS

We conducted a prospective cohort study in which participants with severe sepsis underwent weekly neurologic examinations and nerve conduction studies (NCSs) within 72 hours of developing severe sepsis until intensive care unit (ICU) discharge. Electromyography was preformed if clinical weakness developed or if there was a significant reduction in nerve conduction response amplitudes.

RESULTS

Abnormal NCS were present upon enrollment in 63% of patients (31/48). The presence of abnormal baseline NCS was predictive of hospital mortality (55% vs 0% for patients with normal baseline NCS; p < 0.001). Development of acquired neuromuscular dysfunction could be predicted by NCS done on day 7. Twenty patients remained in the ICU long enough to have serial NCSs; 50% of these patients developed acquired neuromuscular dysfunction. Most patients with acquired neuromuscular dysfunction had electrophysiologic evidence of both critical illness myopathy and critical illness neuropathy.

CONCLUSION

Changes in nerve conduction studies occur in the majority of patients early in the course of severe sepsis and predict the development of acquired neuromuscular dysfunction and mortality in intensive care unit patients. Most patients with acquired neuromuscular dysfunction after sepsis have both critical illness myopathy and critical illness neuropathy.

Authors+Show Affiliations

Department of Neurology, Division of Pulmonary, Allergy, and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, USA. jkhan@emory.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17060568

Citation

Khan, Jaffar, et al. "Early Development of Critical Illness Myopathy and Neuropathy in Patients With Severe Sepsis." Neurology, vol. 67, no. 8, 2006, pp. 1421-5.
Khan J, Harrison TB, Rich MM, et al. Early development of critical illness myopathy and neuropathy in patients with severe sepsis. Neurology. 2006;67(8):1421-5.
Khan, J., Harrison, T. B., Rich, M. M., & Moss, M. (2006). Early development of critical illness myopathy and neuropathy in patients with severe sepsis. Neurology, 67(8), 1421-5.
Khan J, et al. Early Development of Critical Illness Myopathy and Neuropathy in Patients With Severe Sepsis. Neurology. 2006 Oct 24;67(8):1421-5. PubMed PMID: 17060568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early development of critical illness myopathy and neuropathy in patients with severe sepsis. AU - Khan,Jaffar, AU - Harrison,Taylor B, AU - Rich,Mark M, AU - Moss,Marc, PY - 2006/10/25/pubmed PY - 2006/11/11/medline PY - 2006/10/25/entrez SP - 1421 EP - 5 JF - Neurology JO - Neurology VL - 67 IS - 8 N2 - OBJECTIVES: To characterize the prevalence, time of onset, and cause of neuromuscular dysfunction in patients with severe sepsis. METHODS: We conducted a prospective cohort study in which participants with severe sepsis underwent weekly neurologic examinations and nerve conduction studies (NCSs) within 72 hours of developing severe sepsis until intensive care unit (ICU) discharge. Electromyography was preformed if clinical weakness developed or if there was a significant reduction in nerve conduction response amplitudes. RESULTS: Abnormal NCS were present upon enrollment in 63% of patients (31/48). The presence of abnormal baseline NCS was predictive of hospital mortality (55% vs 0% for patients with normal baseline NCS; p < 0.001). Development of acquired neuromuscular dysfunction could be predicted by NCS done on day 7. Twenty patients remained in the ICU long enough to have serial NCSs; 50% of these patients developed acquired neuromuscular dysfunction. Most patients with acquired neuromuscular dysfunction had electrophysiologic evidence of both critical illness myopathy and critical illness neuropathy. CONCLUSION: Changes in nerve conduction studies occur in the majority of patients early in the course of severe sepsis and predict the development of acquired neuromuscular dysfunction and mortality in intensive care unit patients. Most patients with acquired neuromuscular dysfunction after sepsis have both critical illness myopathy and critical illness neuropathy. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/17060568/Early_development_of_critical_illness_myopathy_and_neuropathy_in_patients_with_severe_sepsis_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=17060568 DB - PRIME DP - Unbound Medicine ER -