Factors underlying the early limb muscle weakness in acute quadriplegic myopathy using an experimental ICU porcine model
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Factors underlying the early limb muscle weakness in acute quadriplegic myopathy using an experimental ICU porcine model. / Ochala, Julien; Ahlbeck, Karsten; Radell, Peter J.; Eriksson, Lars I.; Larsson, Lars.
I: PLoS ONE, Bind 6, Nr. 6, e20876, 2011.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Factors underlying the early limb muscle weakness in acute quadriplegic myopathy using an experimental ICU porcine model
AU - Ochala, Julien
AU - Ahlbeck, Karsten
AU - Radell, Peter J.
AU - Eriksson, Lars I.
AU - Larsson, Lars
PY - 2011
Y1 - 2011
N2 - The basic mechanisms underlying acquired generalized muscle weakness and paralysis in critically ill patients remain poorly understood and may be related to prolonged mechanical ventilation/immobilization (MV) or to other triggering factors such as sepsis, systemic corticosteroid (CS) treatment and administration of neuromuscular blocking agents (NMBA). The present study aims at exploring the relative importance of these factors by using a unique porcine model. Piglets were all exposed to MV together with different combinations of endotoxin-induced sepsis, CS and NMBA for five days. Peroneal motor nerve conduction velocity and amplitude of the compound muscle action potential (CMAP) as well as biceps femoris muscle biopsy specimens were obtained immediately after anesthesia on the first day and at the end of the 5-day experimental period. Results showed that peroneal nerve motor conduction velocity is unaffected whereas the size of the CMAP decreases independently of the type of intervention, in all groups after 5 days. Otherwise, despite a preserved size, muscle fibre specific force (maximum force normalized to cross-sectional area) decreased dramatically for animals exposed to MV in combination with CS or/and sepsis. These results suggest that the rapid declines in CMAP amplitude and in force generation capacity are triggered by independent mechanisms with significant clinical and therapeutic implications.
AB - The basic mechanisms underlying acquired generalized muscle weakness and paralysis in critically ill patients remain poorly understood and may be related to prolonged mechanical ventilation/immobilization (MV) or to other triggering factors such as sepsis, systemic corticosteroid (CS) treatment and administration of neuromuscular blocking agents (NMBA). The present study aims at exploring the relative importance of these factors by using a unique porcine model. Piglets were all exposed to MV together with different combinations of endotoxin-induced sepsis, CS and NMBA for five days. Peroneal motor nerve conduction velocity and amplitude of the compound muscle action potential (CMAP) as well as biceps femoris muscle biopsy specimens were obtained immediately after anesthesia on the first day and at the end of the 5-day experimental period. Results showed that peroneal nerve motor conduction velocity is unaffected whereas the size of the CMAP decreases independently of the type of intervention, in all groups after 5 days. Otherwise, despite a preserved size, muscle fibre specific force (maximum force normalized to cross-sectional area) decreased dramatically for animals exposed to MV in combination with CS or/and sepsis. These results suggest that the rapid declines in CMAP amplitude and in force generation capacity are triggered by independent mechanisms with significant clinical and therapeutic implications.
UR - http://www.scopus.com/inward/record.url?scp=79958808182&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0020876
DO - 10.1371/journal.pone.0020876
M3 - Journal article
C2 - 21695079
AN - SCOPUS:79958808182
VL - 6
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 6
M1 - e20876
ER -
ID: 245664352