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Combination of histopathological and electromyographic patterns can help to evaluate functional outcome of critical ill patients with neuromuscular weakness syndromes.
- Source :
-
Critical care (London, England) [Crit Care] 2004 Dec; Vol. 8 (6), pp. R358-66. Date of Electronic Publication: 2004 Sep 10. - Publication Year :
- 2004
-
Abstract
- Introduction: The aim of the study was to describe patterns of neuromuscular weakness using a combination of electromyography and histology, and to evaluate functional outcome in patients following complicated cardiovascular surgery.<br />Methods: Fifteen adults requiring long-term mechanical ventilation (>15 days) following cardiovascular surgery associated with postoperative complications were prospectively included. Electrophysiological and histological analyses (muscle and nerve) were performed when failure to wean from mechanical ventilation associated with peripheral neuromuscular weakness was noticed. Functional disability was evaluated 12 months after surgery.<br />Results: Six patients had a predominantly axonal neuropathy, six presented with myopathy, and three patients had a combination of axonal neuropathy and myopathy. All of them presented with acute tetraparesis and failure to wean from mechanical ventilation. All of the study patients who received corticosteroids exhibited a myopathic pattern (with or without axonopathic changes) but never an axonopathic pattern only. Only two of the eight survivors at 12 months were not ambulatory. These two patients had no detectable compound muscle action potential on electrophysiological examination.<br />Conclusion: The combination of electromyographic evaluation and neuromuscular histological abnormalities could help to identify the type and severity of neuromuscular weakness, in turn helping to evaluate the patient's potential functional prognosis.
- Subjects :
- Adult
Female
Humans
Intensive Care Units
Male
Middle Aged
Muscular Atrophy diagnosis
Muscular Atrophy etiology
Muscular Atrophy physiopathology
Neuromuscular Diseases physiopathology
Paresis diagnosis
Paresis etiology
Paresis physiopathology
Prognosis
Prospective Studies
Recovery of Function
Syndrome
Treatment Failure
Cardiovascular Surgical Procedures rehabilitation
Critical Illness
Electromyography
Neuromuscular Diseases diagnosis
Ventilator Weaning
Subjects
Details
- Language :
- English
- ISSN :
- 1466-609X
- Volume :
- 8
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Critical care (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 15566579
- Full Text :
- https://doi.org/10.1186/cc2925