Systemic inflammatory response syndrome increases immobility-induced neuromuscular weakness.

Fink, H; Helming, M; Unterbuchner, C; Lenz, A; Neff, F; Martyn, JA; Blobner, M

doi:10.1097/CCM.0B013E3181659669

Title:: Systemic inflammatory response syndrome increases immobility-induced neuromuscular weakness.
Document type:: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
Author(s):: Fink, H; Helming, M; Unterbuchner, C; Lenz, A; Neff, F; Martyn, JA; Blobner, M
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:: 3
Pages contribution:: 910-6
Language:: eng
Fulltext / DOI:: doi:10.1097/CCM.0B013E3181659669
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/18431280
Print-ISSN:: 0090-3493
TUM Institution:: Institut für Allgemeine Pathologie und Pathologische Anatomie; Klinik für Anästhesiologie (DHM)
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