Risk factors in critical illness myopathy during the early course of critical illness: a prospective observational study
Open accessAbstract
INTRODUCTION: Non-excitable muscle membrane indicates critical illness myopathy (CIM) during early critical illness. We investigated predisposing risk factors for non-excitable muscle membrane at onset of critical illness. METHODS: We performed sequential measurements of muscle membrane excitability after direct muscle stimulation (dmCMAP) in 40 intensive care unit (ICU) patients selected upon a simplified acute physiology (SAPS-II) score >OR= 20 on 3 successive days within 1 week after ICU admission. We then investigated predisposing risk factors, including the insulin-like growth factor (IGF)-system, inflammatory, metabolic and hemodynamic parameters, as well as suspected medical treatment prior to first occurrence of abnormal dmCMAP. Nonparametric analysis of two-factorial longitudinal data and multivariate analysis were used for statistical analysis. RESULTS: 22 patients showed abnormal muscle membrane excitability during direct muscle stimulation within 7 (5 to 9.25) days after ICU admission. Significant risk factors for the development of impaired muscle membrane excitability in univariate analysis included inflammation, disease severity, catecholamine and sedation requirements, as well as IGF binding protein-1 (IGFBP-I), but did not include either adjunctive hydrocortisone treatment in septic shock, nor administration of neuromuscular blocking agents or aminoglycosides. In multivariate Cox regression analysis, interleukin-6 remained the significant risk factor for the development of impaired muscle membrane excitability (HR 1.006, 95%-CI (1.002 to 1.011), P = 0.002). CONCLUSIONS: Systemic inflammation during early critical illness was found to be the main risk factor for development of CIM during early critical illness. Inflammation-induced impairment of growth-factor mediated insulin sensitivity may be involved in the development of CIM.
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Inflammation and sepsis are major risk factors for ICUAW.
“Inflammation and sepsis are major risk factors for ICUAW.”
From Sepsis induces interleukin 6, gp130/JAK2/STAT3, and muscle wasting (2022) · cites this paper as [8]
The Discussion says systemic inflammation and sepsis-related organ dysfunction are major triggers for critical illness myopathy (CIM), and the Conclusions identify systemic inflammation as the main risk factor during early critical illness. The Introduction connects CIM to ICU-acquired muscle weakness, but the study assesses CIM rather than ICU-acquired weakness as a whole; it also specifies sepsis-related organ dysfunction, not sepsis alone. Page numbers are unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIncreased IL-6 plasma level is a risk factor for Critical Illness Myopathy (CIM) in patients.
“Based on these data and together with our observation that increased IL‐6 plasma level is a risk factor for Critical Illness Myopathy (CIM) in patients, 8 we hypothesized”
From Sepsis induces interleukin 6, gp130/JAK2/STAT3, and muscle wasting (2022) · cites this paper as [8]
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- Authors
- Weber-Carstens, S., Deja, M., Koch, S., Spranger, J., Bubser, F., Wernecke, K. D., Spies, C. D., Spuler, S., & Keh, D.
- Affiliations
- Stiftung Charité (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Venue
- Critical Care
- Published
- 2010-06-18
- Volume
- 14
- Issue
- 3
- Pages
- R119-R119
- ISSN
- 1364-8535 (ISSN-L)
- PMC
- PMC2911767
- OpenAlex
- W2060176865
- Cited by
- 132
- References
- 44
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 10 · 2023: 7 · 2022: 11 · 2021: 7 · 2020: 8 · 2019: 10 · 2018: 4 · 2017: 7 · 2016: 5 · 2015: 12 · 2014: 10 · 2013: 8 · 2012: 12
- FWCI
- 6.91
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Critical Care (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- MDC Repository (Max-Delbrueck-Center for Molecular Medicine) (acceptedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (KFO-192)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Surgery › Muscle and Compartmental Disorders
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- critical illness myopathy, muscle membrane excitability, direct muscle stimulation, risk factors, systemic inflammation, interleukin-6, insulin-like growth factor system, IGF-binding protein-1, insulin sensitivity, catecholamines, sedation, septic shock, cortisol, neuromuscular blocking agents, aminoglycosides, disease severity
- MeSH terms
- Adult, Aged, Female, Humans, Intensive Care Units, Male, Middle Aged, Muscular Diseases, Predictive Value of Tests, Prospective Studies, Risk Factors, Sensitivity and Specificity, Proportional Hazards Models, Critical Illness, Systemic Inflammatory Response Syndrome, Young Adult
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