A SYNDROME OF ACUTE SEVERE MUSCLE NECROSIS IN INTENSIVE-CARE UNIT PATIENTS

被引:114
作者
RAMSAY, DA
ZOCHODNE, DW
ROBERTSON, DM
NAG, S
LUDWIN, SK
机构
[1] KINGSTON GEN HOSP,DEPT PATHOL,KINGSTON K7L 2V7,ONTARIO,CANADA
[2] QUEENS UNIV,KINGSTON K7L 3N6,ONTARIO,CANADA
[3] KINGSTON GEN HOSP,DEPT MED,KINGSTON K7L 2V7,ONTARIO,CANADA
关键词
GLUCOCORTICOIDS; INTENSIVE CARE UNIT; MYOPATHY; MUSCLE NECROSIS; NEUROMUSCULAR BLOCKING AGENTS;
D O I
10.1097/00005072-199307000-00006
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Four septic patients and one asthmatic patient are described who developed a severe paralytic disorder in an intensive care unit (ICU), associated with a rise in serum creatine kinase and a severe necrotizing myopathy. All cases had received non-depolarizing muscle blocking agents and large intravenous doses of glucocorticoids. Three patients developed myoglobinuria. No improvement or very little improvement in muscle function was noted in the four fatal cases. The single survivor recovered his strength after 6 months. This syndrome (''necrotizing myopathy of intensive care'') provides one of the differential diagnoses for ICU-acquired weakness. The myopathy appears to have several interdependent causes and it is proposed that these should be classified as myonecrosis ''priming'' factors (glucocorticoids, myotropic infections, sepsis) and ''triggering'' factors (non-depolarizing muscle blocking agents).
引用
收藏
页码:387 / 398
页数:12
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