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Crit Care Med. 2008 Mar;36(3):910-6. doi: 10.1097/CCM.0B013E3181659669.

Systemic inflammatory response syndrome increases immobility-induced neuromuscular weakness.

Author information

1
Klinik für Anaesthesiologie, Technischen Universität München, Klinikum rechts der Isar, Munich, Germany. h.fink@lrz.tum.de

Abstract

OBJECTIVE:

Inflammation and immobility are comorbid etiological factors inducing muscle weakness in critically ill patients. This study establishes a rat model to examine the effect of inflammation and immobilization alone and in combination on muscle contraction, histology, and acetylcholine receptor regulation.

DESIGN:

Prospective, randomized, experimental study.

SETTING:

Animal laboratory of a university hospital.

SUBJECTS:

Sprague-Dawley rats.

INTERVENTIONS:

To produce systemic inflammation, rats (n = 34) received three consecutive intravenous injections of Corynebacterium parvum on days 0, 4, and 8. Control rats (n = 21) received saline. Both groups were further divided to have one hind limb either immobilized by pinning of knee and ankle joints or sham-immobilized (surgical leg). The contralateral nonsurgical leg of each animal served as control (nonsurgical leg).

MEASUREMENTS AND MAIN RESULTS:

After 12 days, body weight and muscle mass were significantly reduced in all C. parvum animals compared with saline-injected rats. Immobilization led to local muscle atrophy. Normalized to muscle mass, tetanic contraction was reduced in the surgical leg after immobilization (7.64 +/- 1.91 N/g) and after inflammation (8.71 +/- 2.0 N/g; both p < .05 vs. sham immobilization and saline injection, 11.03 +/- 2.26 N/g). Histology showed an increase in inflammatory cells in all C. parvum-injected animals. Immobilization in combination with C. parvum injection had an additive effect on inflammation. Acetylcholine receptors were increased in immobilized muscles and in all muscles of C. parvum-injected animals.

CONCLUSIONS:

The muscle weakness in critically ill patients can be replicated in our novel rat model. Inflammation and immobilization independently lead to muscle weakness.

PMID:
18431280
DOI:
10.1097/CCM.0B013E3181659669
[Indexed for MEDLINE]

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