Steroid-induced myopathy in patients intubated due to exacerbation of chronic obstructive pulmonary disease
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To determine incidence, risk factors and impact on various outcome parameters of the development of acute quadriplegic myopathy in a selected population of critically ill patients.
A prospective cohort study carried out in the intensive care unit of a tertiary-level university hospital.
All patients admitted due to acute exacerbation of chronic obstructive pulmonary disease who required intubation and mechanical ventilation, and received high doses of intravenous corticosteroids.
A neurophysiological study was performed in all cases at the onset of weaning. Muscular biopsy was taken when the neurophysiological study revealed a myopathic pattern.
Measurements and results
Twenty-six patients were enrolled in the study. Nine patients (34.6%) developed myopathy. Only seven patients were treated with muscle relaxants. Histology confirmed the diagnosis in the three patients who underwent muscle biopsy. APACHE II score at admission, the rate of sepsis and the total doses of corticosteroids were significantly higher in patients with myopathy compared with those patients that did not develop it. Myopathy is associated with an increase in the duration of mechanical ventilation [15.4 (9.2) versus 5.7 (3.9) days; p<0.006], the length of ICU stay [23.6 (10.7) versus 11.4 (7.05) days; p<0.003] and hospital stay [33.3 (19.2) versus 21.2 (16.1) days; p<0.034)]. Myopathy was not associated with increased mortality.
In the population under study, severity of illness at admission, the development of sepsis and the total dose of corticosteroids are factors associated with the occurrence of myopathy after the administration of corticosteroids. Myopathy was associated with prolonged mechanical ventilation and in-hospital stay.
- Bolton, (1987) Muscle Nerve 10: pp. 129
- Garnacho-Montero, (2001) Clin Pulmon Med 8: pp. 354 CrossRef
- Leatherman, (1996) Am J Respir Crit Care Med 153: pp. 1686
- Behbehani, (1999) Chest 115: pp. 1627 CrossRef
- Hanson, (1997) Muscle Nerve 20: pp. 1371
- Deconinck, (1998) Neuromusc Disord 8: pp. 186 CrossRef
- American, (1995) Am J Respir Crit Care Med 152: pp. S78
- Garnacho-Montero, (2001) Intensive Care Med 27: pp. 1288 CrossRef
- American, (1992) Chest 101: pp. 1658
- Esteban, (1995) N Engl J Med 332: pp. 345 CrossRef
- Kimura J, Dickins QS (1991) Electrodiagnosis of neuromuscular disorders. In: Neurology in clinical practice. principal of diagnosis and management. Bradley WG, Daroff RB, Fenichel GM, DC Marsden (eds), Britterworth-Heinemann, Boston, pp 452–467
- Lacomis, (1996) Ann Neurology 40: pp. 645
- Adnet, (2001) Intensive Care Med 27: pp. 1729 CrossRef
- De, (2002) JAMA 288: pp. 2859
- Wilcox, (1996) Am J Resp Crit Care Med 153: pp. 1611
- Reid, (2002) Am J Respir Crit Care Med 166: pp. 479 CrossRef
- Latronico, (1996) Lancet 347: pp. 1579 CrossRef
- Tiao, (1997) J Clin Invest 99: pp. 163
- De, (2004) Intensive Care Med 30: pp. 1117 CrossRef
- Steroid-induced myopathy in patients intubated due to exacerbation of chronic obstructive pulmonary disease
Intensive Care Medicine
Volume 31, Issue 1 , pp 157-161
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- Chronic obstructive pulmonary disease
- Mechanical ventilation
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- Author Affiliations
- 1. Intensive Care Unit, University Hospital Virgen del Rocío, Avenida Manuel Siurot s/n, 41013, Sevilla, Spain
- 2. Department of Clinical Neurophysiology, University Hospital Virgen del Rocío, Avenida Manuel Siurot s/n, 41013, Sevilla, Spain
- 3. Department of Pathology, University Hospital Virgen del Rocío, Avenida Manuel Siurot s/n, 41013, Sevilla, Spain