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Increased Early Systemic Inflammation in ICU-Acquired Weakness; A Prospective Observational Cohort Study.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Witteveen, Esther Wieske, Luuk Poll, Tom Van Der Schaaf, Marike Van Der Schaik, Ivo N. Van Schultz, Marcus J. Verhamme, Camiel Horn, Janneke |
| Copyright Year | 2017 |
| Abstract | OBJECTIVES To investigate whether patients who develop ICU-acquired weakness have a different pattern of systemic inflammatory markers compared with critically ill patients who do not develop ICU-acquired weakness. DESIGN Prospective observational cohort study. SETTING Mixed medical-surgical ICU of a tertiary care hospital in the Netherlands. PATIENTS Newly admitted critically ill patients, greater than or equal to 48 hours on mechanical ventilation with a nonneurologic ICU admission diagnosis, were included. INTERVENTIONS A panel of systemic inflammatory markers and soluble vascular adhesion molecules were measured in plasma samples of day 0, 2, and 4 after ICU admission. ICU-acquired weakness was diagnosed by manual muscle strength testing as soon as patients were awake and attentive. MEASUREMENTS AND MAIN RESULTS Ninety-nine of 204 included patients developed ICU-acquired weakness. Principal component regression analysis, adjusted for confounders, showed that principal component 1, mainly loaded with interleukin-6, interleukin-8, interleukin-10, and fractalkine, was significantly higher in patients who developed ICU-acquired weakness (odds ratio, 1.35 [95% CI, 1.18-1.55]). Partial least squares-discriminant analysis also showed that these markers were the most important discriminative markers. Mixed-effects models of these markers showed that ICU-acquired weakness was associated with an independent 1.5- to two-fold increase in these markers. CONCLUSIONS Systemic inflammation is increased in patients who develop ICU-acquired weakness compared with patients who do not develop ICU-acquired weakness in the first 4 days after ICU admission. This finding is consistent when adjusted for confounders, like disease severity. A group consisting of interleukin-6, interleukin-8, interleukin-10, and fractalkine was identified to be the most important. |
| Starting Page | 972 |
| Ending Page | 979 |
| Page Count | 8 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://ssr-eus-go-csi.cloudapp.net/v1/assets?wkmrid=JOURNAL/ccme/beta/00003246-201706000-00007/root/v/2017-05-16T085008Z/r/application-pdf |
| PubMed reference number | 28350642v1 |
| Alternate Webpage(s) | https://doi.org/10.1097/CCM.0000000000002408 |
| DOI | 10.1097/CCM.0000000000002408 |
| Journal | Critical care medicine |
| Volume Number | 45 |
| Issue Number | 6 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Acquired Immunodeficiency Syndrome CX3CL1 gene Critical Illness Inflammation Intensive Care Units, Neonatal Interleukin-8 Least-Squares Analysis Lupus Erythematosus, Systemic Mechanical ventilation Muscle Weakness Myalgia Patients Respiration Tertiary Healthcare intensive care unit |
| Content Type | Text |
| Resource Type | Article |
