King's College London, Division of Asthma, Allergy and Lung Biology, Department of Respiratory Medicine, UK.
King's College London, Department of Palliative Care, Cicely Saunders Institute, UK.
Muscle Nerve. 2018 Jun;57(6):964-972. doi: 10.1002/mus.26049. Epub 2018 Mar 3.
Contemporaneous measures of muscle architecture and force have not previously been conducted during critical illness to examine their relationship with intensive care unit (ICU)-acquired weakness.
Ankle dorsiflexor muscle force (ADMF) with high-frequency electrical peroneal nerve stimulation and skeletal muscle architecture via ultrasound were measured in 21 adult, critically ill patients, 16 at ICU admission.
Thirteen patients were measured on 2 occasions. Among these, 10 who were measured at ICU admission demonstrated muscle weakness. Despite significant reductions in tibialis anterior (Δ = -88.5 ± 78.8 mm , P = 0.002) and rectus femoris (Δ = -126.1 ± 129.1 mm , P = 0.006) cross-sectional areas between occasions, ADMF did not change (100-HZ ankle dorsiflexor force 9.8 [IQR, 8.0-14.4] kg vs. 8.6 (IQR, 6.7-19.2) kg, P = 0.9).
Muscle weakness was evident at ICU admission. No additional decrements were observed 7 days later despite significant reductions in muscle size. These data suggest that not all ICU weakness is truly "acquired" and questions our understanding of muscle function during critical illness. Muscle Nerve 57: 964-972, 2018.
目前尚未在危重病期间进行肌肉结构和力量的同期测量，以检查其与重症监护病房（ICU）获得性肌无力的关系。
通过高频腓肠神经电刺激和超声测量 21 名成年危重病患者的踝背屈肌力量（ADMF）和骨骼肌结构，其中 16 名患者在 ICU 入院时进行了测量。
其中 13 名患者进行了 2 次测量。在这些患者中，10 名患者在 ICU 入院时表现出肌肉无力。尽管在前胫骨（Δ=-88.5±78.8mm，P=0.002）和股直肌（Δ=-126.1±129.1mm，P=0.006）横截面积方面存在显著降低，但 ADMF 并未发生变化（100-HZ 踝背屈肌力量 9.8[IQR，8.0-14.4]kg 与 8.6[IQR，6.7-19.2]kg，P=0.9）。
在 ICU 入院时已经出现肌肉无力。尽管肌肉大小明显减少，但 7 天后并未观察到进一步的下降。这些数据表明，并非所有 ICU 肌无力都是真正的“获得性”，这对我们在危重病期间对肌肉功能的理解提出了质疑。《肌肉神经》57：964-972，2018 年。
