Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: The role of inflammation in ICU-acquired weakness. | Winkelman Critical Care 2010 14 186 http content 14 4 186 CRITICAL CARE COMMENTARY L__ The role of inflammation in ICU-acquired weakness Chris Winkelman See related research by Weber-Carstens etal. http content 14 3 R119 Abstract A pilot observational study by Weber-Carstens and colleagues contributes to a mechanistic explanation of the puzzling and complex phenomena of ICU-acquired weakness ICU-AW . The authors suggest systemic inflammatory-mediated pathology is the most significant risk factor for ICU-AW. While this finding is somewhat equivocal it provides important direction for future investigations and illustrates the challenges of interpreting significance in small observational studies. The pilot observational study by Weber-Carstens and colleagues 1 provides important contributions to a mechanistic explanation of the puzzling and complex phenomena of ICU-acquired weakness ICU-AW . Earlier findings from this research group suggested that ICU-AW is primarily a myopathy 2 and confirmed that initial pathology manifests on average 7 days after ICU admission among the most severely ill 2-4 . In the current subanalysis with 40 of the original 52 subjects multiple factors were examined for association with myopathy molecular IL-6 C-reactive protein CRP and insulin growth factor binding protein IGFBP -1 serum osmolarity medication use norepinepherine dobutamine hydrocortisone aminoglycosides analgesics sedatives and neuromuscular blocking agents and multisystem factors simplified acute physiology SAPS-2 and sequential organ failure assessment SOFA scores . The authors suggest systemic inflammatory-mediated pathology is the most significant risk factor for ICU-AW. The results on IL-6 show that its effects are actually quite modest. While IL-6 had a significant contribution to the statistical model the hazard ratio of indicated a higher IL-6 230 picograms ml is little better than chance in predicting inexcitable muscle membranes
