Critical Illness Myopathy: Diagnostic Approach and Resulting Therapeutic Implications.
Critical Illness Myopathy: Diagnostic Approach and Resulting Therapeutic Implications.
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DOI：
10.1007/s11940-022-00714-7
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发表时间：
2022
影响因子：
2
通讯作者：
Z'Graggen WJ
中科院分区：
文献类型：
--
作者：
Rodriguez B;Larsson L;Z'Graggen WJ
重症肌病(CIM)是重症监护治疗中常见的神经肌肉并发症，与发病率和死亡率增加有关。目前的诊断指南包括临床和电生理标准以及肌肉活检，并且只允许在疾病的晚期进行诊断。到目前为止，除了对症和康复干预外，还没有治疗CIM的方法。在这篇综述中，我们讨论了不同的诊断方法，并描述了CIM的新的治疗可能性。在评估的诊断方法中，一种新的电生理技术测量肌肉兴奋性最有可能比目前的指南更早地诊断CIM，从而可能促进未来的病理生理和治疗研究的进行。尽管仍然缺乏临床试验，但在动物模型中，BGP-15、伏洛龙和鲁索利替尼已被证明具有抗炎作用，减少肌肉损耗，改善肌肉功能和存活率。近年来，对CIM的早期和确证诊断有希望的方法已经开发出来，但仍有待验证。对新型药理干预措施的实验研究显示，在预防CIM治疗方面取得了良好的结果，但未来还需要进行临床研究，以研究这些药物的有效性和安全性。
Critical illness myopathy (CIM) is a common neuro-muscular complication of intensive care treatment associated with increased morbidity and mortality. The current guidelines for diagnosis include clinical and electrophysiological criteria as well as a muscle biopsy, and allow diagnosis only at an advanced stage of the disease. To date, there is no treatment for CIM available, apart from symptomatic and rehabilitative interventions. In this review, we discuss different diagnostic approaches and describe new treatment possibilities for CIM. Of the diagnostic approaches evaluated, a new electrophysiological technique for measuring muscle excitability has the greatest potential to allow earlier diagnosis of CIM than the current guidelines do and thereby may facilitate the conduction of future pathophysiological and therapeutic studies. Although clinical trials are still lacking, in animal models, BGP-15, vamorolone, and ruxolitinib have been shown to have anti-inflammatory effects, to reduce muscle wasting and to improve muscle function and survival. In recent years, promising methods for early and confirmatory diagnosis of CIM have been developed, but still need validation. Experimental studies on novel pharmacological interventions show promising results in terms of preventive CIM treatments, but future clinical studies will be needed to study the effectiveness and safety of these drugs.
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DOI：
10.1016/j.clinph.2021.03.016
发表时间：
2021-07
期刊：
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
影响因子：
--
作者：
Frithiof R;Rostami E;Kumlien E;Virhammar J;Fällmar D;Hultström M;Lipcsey M;Ashton N;Blennow K;Zetterberg H;Punga AR
通讯作者：
Punga AR
影响因子：
8.8
作者：
Fan E;Dowdy DW;Colantuoni E;Mendez-Tellez PA;Sevransky JE;Shanholtz C;Himmelfarb CR;Desai SV;Ciesla N;Herridge MS;Pronovost PJ;Needham DM
通讯作者：
Needham DM
影响因子：
38.9
作者：
Coakley, JH;Nagendran, K;Hinds, CJ
通讯作者：
Hinds, CJ
影响因子：
38.9
作者：
De Jonghe, B;Bastuji-Garin, S;Brochard, L
通讯作者：
Brochard, L
影响因子：
8.8
作者：
Dinglas, Victor D.;Friedman, Lisa Aronson;Needham, Dale M.
通讯作者：
Needham, Dale M.