Highlights
- •We summarize current knowledge on inflammation in muscle and nerve tissue in ICU-AW.
- •Direct histological evidence of muscle and nerve inflammation in ICU-AW is limited.
- •A detrimental role for local inflammation in ICU-AW cannot be established.
- •Various inflammatory mediators are present in muscle and nerve tissue in ICU-AW.
Abstract
Background
Intensive care unit-acquired weakness (ICU-AW) is an important complication of critical
illness. The main risk factors, sepsis and the systemic inflammatory response syndrome,
suggest an inflammatory pathogenesis. In this systematic translational review we summarize
current knowledge on inflammation in muscle and nerve tissue in animal models of ICU-AW
and in critically ill patients with ICU-AW.
Methods
We conducted a systematic search in the databases of MEDLINE, EMBASE and Web of Science
using predefined search and selection criteria. From the included studies we extracted
data on study characteristics and on inflammation in muscle and nerve tissue.
Results
The literature search yielded 349 unique articles, of which 12 animal studies and
20 human studies fulfilled the in- and exclusion criteria. All studies had important
shortcomings in methodological quality. In the animal studies, inflammation of muscle
tissue was found, represented by cellular infiltration and increased local levels
of various inflammatory mediators. In human studies, high levels of various inflammatory
mediators were found in muscle and nerve tissue of ICU-AW patients.
Conclusion
This systematic translational review suggests a role for local inflammation in ICU-AW,
but the available evidence is limited and studies have severe methodological limitations.
Abbreviations:
ICU-AW (intensive care unit-acquired weakness), CIP (critical illness polyneuropathy), CIM (critical illness myopathy), CINM (critical illness neuromyopathy), ICU (intensive care unit), SIRS (systemic inflammatory response syndrome), LPS (lipopolysaccharide), MAC (membrane attack complex), MODS (multiple organ dysfunction syndrome), NMD (neuromuscular disease)Keywords
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Article info
Publication history
Published online: July 16, 2014
Accepted:
July 7,
2014
Received in revised form:
July 1,
2014
Received:
April 7,
2014
Identification
Copyright
© 2014 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
