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Document type:
journal article 
Author(s):
Fink, H; Helming, M; Unterbuchner, C; Lenz, A; Neff, F; Martyn, JA; Blobner, M 
Title:
Systemic inflammatory response syndrome increases immobility-induced neuromuscular weakness. 
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. 
Journal title abbreviation:
Crit Care Med 
Year:
2008 
Journal volume:
36 
Journal issue:
Pages contribution:
910-6 
Language:
eng 
Print-ISSN:
0090-3493 
TUM Institution:
sthesiologie; r Allgemeine Pathologie und pathologische Anatomie