A framework for diagnosing and classifying intensive care unit-acquired weakness

Critical Care Medicine

Volumn 37, Issue SUPPL. 10, 2009, Pages

  Stevens, Robert D ^a   Marshall, Scott A ^a,b   Cornblath, David R ^a   Hoke, Ahmet ^a   Needham, Dale M ^a   De Jonghe, Bernard ^c   Ali, Naeem A ^d   Sharshar, Tarek ^e  

^a JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b Uniformed Services University of the Health Sciences   (France)

^c CENTRE HOSPITALIER INTERCOMMUNAL   (France)

^d OHIO STATE UNIVERSITY   (United States)

^e LABORATOIRE DES SCIENCES DU CLIMAT ET DE L ENVIRONNEMENT   (France)

Author keywords

Critical illness myopathy; Critical illness neuromyopathy; Critical illness polyneuropathy; Direct muscle stimulation; Electromyogram; Intensive care unit acquired paresis; Intensive care unit acquired weakness; Nerve conduction studies; Prolonged neuromuscular blockade

Indexed keywords

CREATINE KINASE; GLUCOCORTICOID;

CLINICAL ASSESSMENT; CONFERENCE PAPER; CREATINE KINASE BLOOD LEVEL; CRITICAL ILLNESS MYOPATHY; CRITICAL ILLNESS NEUROMYOPATHY; CRITICAL ILLNESS POLYNEUROPATHY; DISEASE CLASSIFICATION; ELECTROMYOGRAPHY; ELECTROPHYSIOLOGY; HUMAN; HYPERGLYCEMIA; INTENSIVE CARE UNIT ACQUIRED WEAKNESS; MULTIPLE ORGAN FAILURE; MUSCLE ACTION POTENTIAL; MUSCLE BIOPSY; MUSCLE EXCITATION; MUSCLE WEAKNESS; MYOPATHY; NERVE CONDUCTION; NERVE POTENTIAL; NEUROMUSCULAR BLOCKING; NEUROMUSCULAR DISEASE; POLYNEUROPATHY; PRIORITY JOURNAL; SCORING SYSTEM; ULTRASOUND;

EID: 70350517765     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0b013e3181b6ef67     Document Type: Conference Paper

References (120)

1. Hippocrates, Kelly EC: The Theory and Practice of Medicine. New York, Philosophical Library, 1964
2. Osier W: The Principles and Practice of Medicine, Designed for the Use of Practitioners and Students of Medicine. New York, D. Appleton and Company, 1892
3. MacFarlane IA, Rosenthal FD: Severe myopathy after status asthmaticus. Lancet 1977; 2:615
4. Douglass JA, Tuxen DV, Home M, et al: Myopathy in severe asthma. Am Rev Respir Dis 1992; 146:517-519
5. Dahlen B, von Scheele C: [Myopathy associated with intensive care]. Lakartidningen 1983; 80:3215-3216
6. Hirano M, Ott BR, Raps EC, et al: Acute quadriplegic myopathy: A complication of treatment with steroids, nondepolarizing blocking agents, or both. Neurology 1992; 42:2082-2087
7. Blackie JD, Gibson P, Murree-Allen K, et al: Acute myopathy in status asthmaticus. Clin Exp Neurol 1993; 30:72-81
8. 8. Coakley JH, Nagendran K, Honavar M, et al: Preliminary observations on the neuromuscular abnormalities in patients with orǵan failure and sepsis. Intensive Care Med 1993; 19:323-328 9. Ramsay DA, Zochodne DW, Robertson DM, et al: A syndrome of acute severe muscle necrosis in intensive care unit patients. J Neuropathol Exp Neurol 1993; 52: 387-398 (Pubitemid 23284794)
9. 10. Zochodne DW, Ramsay DA, Saly V, et al: Acute necrotizinǵ myopathy of intensive care: Electrophysioloǵical studies. Muscle Nerve 1994; 17:285-292 (Pubitemid 24080207)
10. 11. Lacomis D, Giuliani MJ, Van Cott A, et al: Acute myopathy of intensive care: Clinical, electromyographic, and pathological aspects. Ann Neurol 1996; 40:645-654 (Pubitemid 26357890)
11. Latronico N, Fenzi F, Recupero D, et al: Critical illness myopathy and neuropathy. Lancet 1996; 347:1579-1582
12. Sander HW, Golden M, Danon MJ: Quadriplegic areflexic ICU illness: Selective thick filament loss and normal nerve histoloǵy. Muscle Nerve 2002; 26:499-505
13. Danon MJ, Carpenter S: Myopathy with thick filament (myosin) loss following prolonged paralysis with vecuronium during steroid treatment. Muscle Nerve 1991; 14: 1131-1139
14. Lacomis D, Zochodne DW, Bird SJ: Critical illness myopathy. Muscle Nerve 2000; 23: 1785-1788
15. Bolton CF, Gilbert JJ, Hahn AF, et al: Polyneuropathy in critically ill patients. J Neurol Neurosurg Psychiatry 1984; 47: 1223-1231
16. Bolton CF, Laverty DA, Brown JD, et al: Critically ill polyneuropathy: Electrophysiological studies and differentiation from Guillain-Barre syndrome. J Neurol Neurosurg Psychiatry 1986; 49:563-573
17. Zochodne DW, Bolton CF, Wells GA, et al: Critical illness polyneuropathy. A complication of sepsis and multiple organ failure. Brain 1987; 110:819-841
18. Witt NJ, Zochodne DW, Bolton CF, et al: Peripheral nerve function in sepsis and multiple organ failure. Chest 1991; 99: 176-184
19. 20. Lacomis D, Petrella .JT, Giuliani MJ: Causes of neuromuscular weakness in the intensive care unit: A study of ninety-two patients. Muscle Nerve 1998; 21:610-617 (Pubitemid 28185889)
20. 21. Leijten FS, De Weerd AW, Poortvliet DC, et al: Critical illness polyneuropathy in multiple organ dysfunction syndrome and weaning from the ventilator. Intensive Care Med 1996; 22:856-861 (Pubitemid 26340630)
21. 22. Berek K, Margreiter J, Willeit J, et al: Polyneuropathies in critically ill patients: A prospective evaluation. Intensive Care Med 1996; 22:849-855 (Pubitemid 26340629)
22. 23. Hund EF, Fogel W, Krieger D, et al: Critical illness polyneuropathy: Clinical findings and outcomes of a frequent cause of neuromuscular weaning failure. Crit Care Med 1996; 24:1328-1333 (Pubitemid 26262406)
23. 24. Coakley JH, Nagendran K, Yarwood GD, et al: Patterns of neurophysiological abnor- mality in prolonged critical illness. Intensive Care Med 1998; 24:801-807 (Pubitemid 28431668)
24. 25. Latronico N, Candiani A: Predominant involvement of motor fibres in patients with critical illness polyneuropathy. Br J Anaesth 1997; 79:547-548 (Pubitemid 27423343)
25. 26. Zifko UA, Zipko HT, Bolton CF: Clinical and electrophysiological findings in critical illness polyneuropathy. J Neurol Sci 1998; 159:186-193 (Pubitemid 28384528)
26. 27. Garnacho-Montero J, Madrazo-Osuna J, Garcia-Garmendia JL, et al: Critical illness polyneuropathy: Risk factors and clinical consequences. A cohort study in septic patients. Intensive Care Med 2001; 27: 1288-1296 (Pubitemid 32758926)
27. 28. Woittiez AJ, Veneman TF, Rakic S: Critical illness polyneuropathy in patients with systemic inflammatory response syndrome or septic shock. Intensive Care Med 2001; 27: 613 (Pubitemid 32250094)
28. 29. Bednarik J, Lukas Z, Vondracek P: Critical illness polyneuromyopathy: The electrophysiological components of a complex entity. Intensive Care Med 2003; 29: 1505-1514 (Pubitemid 37153595)
29. 30. De Jonghe B, Sharshar T, Lefaucheur JP, et al: Paresis acquired in the intensive care unit: A prospective multicenter study. JAMA 2002; 288:2859-2867 (Pubitemid 35425072)
30. 31. De Jonghe B, Bastuji-Garin S, Sharshar T, et al: Does ICU-acquired paresis lengthen weaning from mechanical ventilation? Intensive Care Med 2004; 30:1117-1121 (Pubitemid 38833364)
31. 32. Smith CL, Hunter JM, Jones RS: Vecuronium infusions in patients with renal failure in an ITU. Anaesthesia 1987; 42: 387-393 (Pubitemid 17049710)
32. 33. Segredo V, Matthay MA, Sharma ML, et al: Prolonged neuromuscular blockade after long-term administration of vecuronium in two critically ill patients. Anesthesiology 1990; 72:566-570 (Pubitemid 20095379)
33. Lagasse RS, Katz RI, Petersen M, et al: Prolonged neuromuscular blockade following vecuronium infusion. J Clin Anesth 1990; 2:269-271
34. 35. Partridge BL, Abrams JH, Bazemore C, et al: Prolonged neuromuscular blockade after long-term infusion of vecuronium bromide in the intensive care unit. Crit Care Med 1990; 18:1177-1179 (Pubitemid 20364064)
35. Rossiter A, Souney PF, McGowan S, et al: Pancuronium-induced prolonged neuromuscular blockade. Crit Care Med 1991; 19:1583-1587
36. Vanderheyden BA, Reynolds HN, Gerold KB, et al: Prolonged paralysis after longterm vecuronium infusion. Crit Care Med 1992; 20:304-307
37. Segredo V, Caldwell JE, Matthay MA, et al: Persistent paralysis in critically ill patients after long-term administration of vecuronium. N Engl J Med 1992; 327:524-528
38. Gooch JL, Moore MH, Ryser DK: Prolonged paralysis after neuromuscular junction blockade: Case reports and electrodiagnos- tic findings. Arch Phys Med Rehabil 1993; 74:1007-1011
39. 40. Davis NA, Rodgers JE, Gonzalez ER, et al: Prolonged weakness after cisatracurium infusion: A case report. Crit Care Med 1998; 26:1290-1292 (Pubitemid 28334988)
40. Bizzarri-Schmid MD, Desai SP: Prolonged neuromuscular blockade with atracurium. Can Anaesth Soc J 1986; 33:209-212
41. Hoey LL, Joslin SM, Nahum A, et al: Prolonged neuromuscular blockade in two critically ill patients treated with atracurium. Pharmacotherapy 1995; 15:254-259
42. 43. Leatherman JW, Fluegel WL, David WS, et al: Muscle weakness in mechanically ventilated patients with severe asthma. Am J Respir Crit Care Med 1996; 153:1686-1690 (Pubitemid 26141357)
43. Watling SM, Dasta JF: Prolonged paralysis in intensive care unit patients after the use of neuromuscular blocking agents: A review of the literature. Crit Care Med 1994; 22: 884-893
44. 45. Lamer C, Harboun M, Knani L, et al: Quality of life after complicated elective surgery requiring intensive care. Intensive Care Med 2004; 30:1594-1601 (Pubitemid 39094961)
45. 46. Kaarlola A, Pettila V, Kekki P: Quality of life six years after intensive care. Intensive Care Med 2003; 29:1294-1299 (Pubitemid 37041158)
46. 47. Schelling G, Stoll C, Haller M, et al: Healthrelated quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome. Crit Care Med 1998; 26:651-659 (Pubitemid 28201410)
47. Clavet H, Hébert PC, Fergusson D, et al: Joint contracture following prolonged stay in the intensive care unit. CMAJ 2008; 178: 691-697
48. 49. Cheung AM, Tansey CM, Tomlinson G, et al: Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med 2006; 174:538-544 (Pubitemid 44330546)
49. 50. Herridge MS, Cheung AM, Tansey CM, et al: One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med 2003; 348:683-693 (Pubitemid 36237037)
50. 51. Angel MJ, Bril V, Shannon P, et al: Neuromuscular function in survivors of the acute respiratory distress syndrome. Can J Neurol Sci 2007; 34:427-432 (Pubitemid 350248270)
51. Leijten FS, Harinck-de Weerd JE, Poortvliet DC, et al: The role of polyneuropathy in motor convalescence after prolonged mechanical ventilation. JAMA 1995; 274: 1221-1225
52. Zifko UA: Long-term outcome of critical illness polyneuropathy. Muscle Nerve Suppl 2000; 9:S49-S52
53. Fletcher SN, Kennedy DD, Ghosh IR, et al: Persistent neuromuscular and neurophysiologic abnormalities in long-term survivors of prolonged critical illness. Crit Care Med 2003; 31:1012-1016
54. Kerbaul F, Brousse M, Collart F, et al: Combination of histopathological and electromyographic patterns can help to evaluate functional outcome of critical ill patients with neuromuscular weakness syndromes. Crit Care 2004; 8:R358-R366
55. 56. Guarneri B, Bertolini G, Latronico N: Longterm outcome in patients with critical illness myopathy or neuropathy: The Italian multicentre CRIMYNE study. J Neurol Neurosurg Psychiatry 2008; 79:838-841 (Pubitemid 351914738)
56. 57. de Seze M, Petit H, Wiart L, et al: Critical illness polyneuropathy. A 2-year follow-up study in 19 severe cases. Eur Neurol 2000; 43:61-69 (Pubitemid 30114094)
57. 58. De Jonghe B, Bastuji-Garin S, Durand MC, et al: Respiratory weakness is associated with limb weakness and delayed weaning in critical illness. Crit Care Med 2007; 35: 2007-2015 (Pubitemid 47326435)
58. 59. Garnacho-Montero J, Amaya-Villar R, Garcia-Garmendia JL, et al: Effect of critical illness polyneuropathy on the withdrawal from mechanical ventilation and the length of stay in septic patients. Crit Care Med 2005; 33:349-354 (Pubitemid 40216548)
59. 60. Bercker S, Weber-Carstens S, Deja M, et al: Critical illness polyneuropathy and myopathy in patients with acute respiratory distress syndrome. Crit Care Med 2005; 33: 711-715 (Pubitemid 40504376)
60. 61. Amaya-Villar R, Garnacho-Montero J, Garcia-Garmendia JL, et al: Steroid-induced myopathy in patients intubated due to exacerbation of chronic obstructive pulmonary disease. Intensive Care Med 2005; 31: 157-161 (Pubitemid 40174297)
61. 62. Rudis MI, Guslits BJ, Peterson EL, et al: Economic impact of prolonged motor weakness complicating neuromuscular blockade in the intensive care unit. Crit Care Med 1996; 24:1749-1756 (Pubitemid 26347392)
62. Ali NA, O'Brien JM Jr, Hoffmann SP, et al: Acquired weakness, handgrip strength, and mortality in critically ill patients. Am J Respir Crit Care Med 2008; 178:261-268
63. 64. Hermans G, De Jonghe B, Bruyninckx F, et al: Interventions for preventing critical illness polyneuropathy and critical illness myopathy. Cochrane Database Syst Rev 2009; (1):CD006832 (Pubitemid 351805263)
64. Schweickert WD, Pohlman MC, Pohlman AS, et al: Early physical and occupational therapy in mechanically ventilated, critically ill patients: A randomised controlled trial. Lancet 2009; 373:1874-1882
65. Morris PE, Goad A, Thompson C, et al: Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med 2008; 36:2238-2243
66. 67. Bailey P, Thomsen GE, Spuhler VJ, et al: Early activity is feasible and safe in respiratory failure patients. Crit Care Med 2007; 35:139-145 (Pubitemid 46035689)
67. 68. Leijten F, Poortvliet DC, de Weerd AW: The neurological examination in the assessment of polyneuropathy in mechanically ventilated patients. Eur J Neurol 1997; 4:124-129 (Pubitemid 27254152)
68. Latronico N, Peli E, Botteri M: Critical illness myopathy and neuropathy. Curr Opin Crit Care 2005; 11:126-132
69. 70. Morris C, Trinder JT: Electrophysiology adds little to clinical signs in critical illness polyneuropathy and myopathy. Crit Care Med 2002; 30:2612 (Pubitemid 35351900)
70. 71. De Jonghe B, Finfer S: Critical illness neuromyopathy: From risk factors to prevention. Am J Respir Crit Care Med 2007; 175: 424-425 (Pubitemid 46354243)
71. Schweickert WD, Hall J: ICU-acquired weakness. Chest 2007; 131:1541-1549
72. Lefaucheur JP, Nordine T, Rodriguez P, et al: Origin of ICU acquired paresis determined by direct muscle stimulation. J Neurol Neurosurg Psychiatry 2006; 77:500-506
73. 74. Trojaborg W, Weimer LH, Hays AP: Electrophysiologic studies in critical illness associated weakness: Myopathy or neuropathy - A reappraisal. Clin Neurophysiol 2001; 112: 1586-1593 (Pubitemid 32763240)
74. Op de Coul AA, Verheul GA, Leyten AC, et al: Critical illness polyneuromyopathy after artificial respiration. Clin Neurol Neurosurg 1991; 93:27-33
75. De Jonghe B, Cook D, Sharshar T, et al: Acquired neuromuscular disorders in critically ill patients: A systematic review. Groupe de Reflexion et d'Etude sur les Neuromyopathies En Reanimation. Intensive Care Med 1998; 24:1242-1250
76. Stevens RD, Dowdy DW, Michaels RK, et al: Neuromuscular dysfunction acquired in critical illness: A systematic review. Intensive Care Med 2007; 33:1876-1891
77. Herridge MS: Building consensus on ICUacquired weakness. Intensive Care Med 2009; 35:1-3
78. Deem S: Intensive-care-unit-acquired muscle weakness. Respir Care 2006; 51: 1042-1052; discussion 1052-1053
79. Aids to the Examination of the Peripheral Nervous System. London, Philadelphia, Bailliere Tindall on behalf of the guarantors of Brain, 1986
80. 81. van der Meche FG, Kleyweg RP, Meulstee J, et al: High-dose intravenous gammaglobulin in Guillain-Barre syndrome. Ann Neurol 1988; 24:588 (Pubitemid 18246901)
81. Kleyweg RP, van der Meche FG, Schmitz PI: Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barre syndrome. Muscle Nerve 1991; 14:1103-1109
82. van der Schaaf M, Dettling DS, Beelen A, et al: Poor functional status immediately after discharge from an intensive care unit. Disabil Rehabil 2008; 30:1812-1818
83. Oh SJ: Clinical Electromyography: Nerve Conduction Studies. Baltimore, University Park Press, 1984
84. 85. Eikermann M, Koch G, Gerwig M, et al: Muscle force and fatigue in patients with sepsis and multiorgan failure. Intensive Care Med 2006; 32:251-259 (Pubitemid 43251146)
85. Ginz HF, Iaizzo PA, Urwyler A, et al: Use of non-invasive-stimulated muscle force assessment in long-term critically ill patients: A future standard in the intensive care unit? Acta Anaesthesiol Scand 2008; 52:20-27
86. Preston DC, Shapiro BE: Electromyography and Neuromuscular Disorders: ClinicalElectrophysiologic Correlations. Boston, Butterworth-Heinemann, 1998
87. 88. Bolton CF: Assessment of respiratory function in the intensive care unit. Can J Neurol Sci 1994; 21:S28-S34 (Pubitemid 24174912)
88. Maher J, Rutledge F, Remtulla H, et al: Neuromuscular disorders associated with failure to wean from the ventilator. Intensive Care Med 1995; 21:737-743
89. Bolton CF, Grand'Maison F, Parkes A, et al: Needle electromyography of the diaphragm. Muscle Nerve 1992; 15:678-681
90. Jablecki CK: Electrodiagnostic evaluation of patients with myasthenia gravis and related disorders. Neurol Clin 1985; 3:557-572
91. 92. Stalberg E, Trontelj JV: The study of normal and abnormal neuromuscular transmission with single fibre electromyography. J Neurosci Methods 1997; 74:145-154 (Pubitemid 27288269)
92. 93. Bolton CF: Electrophysiologic studies of critically ill patients. Muscle Nerve 1987; 10:129-135 (Pubitemid 17004216)
93. Latronico N: Neuromuscular alterations in the critically ill patient: Critical illness myopathy, critical illness neuropathy, or both? Intensive Care Med 2003; 29:1411-1413
94. Bolton CF: Neuromuscular manifestations of critical illness. Muscle Nerve 2005; 32: 140-163
95. De Jonghe B, Lacherade JC, Durand MC, et al: Critical illness neuromuscular syndromes. Crit Care Clin 2006; 22:805-818; abstract xi
96. Rich MM, Teener JW, Raps EC, et al: Muscle is electrically inexcitable in acute quadriplegic myopathy. Neurology 1996; 46:731-736
97. Rich MM, Bird SJ, Raps EC, et al: Direct muscle stimulation in acute quadriplegic myopathy. Muscle Nerve 1997; 20:665-673
98. Harris ML, Luo YM, Watson AC, et al: Adductor pollicis twitch tension assessed by magnetic stimulation of the ulnar nerve. Am J Respir Crit Care Med 2000; 162: 240-245
99. Showalter CJ, Engel AG: Acute quadriplegic myopathy: Analysis of myosin isoforms and evidence for calpain-mediated proteolysis. Muscle Nerve 1997; 20:316-322
100. 101. Gutmann L, Blumenthal D, Schochet SS: Acute type II myofiber atrophy in critical illness. Neurology 1996; 46:819-821 (Pubitemid 26099654)
101. Sher JH, Shafiq SA, Schutta HS: Acute myopathy with selective lysis of myosin filaments. Neurology 1979; 29:100-106
102. Williams AB, Decourten-Myers GM, Fischer JE, et al: Sepsis stimulates release of myofilaments in skeletal muscle by a calciumdependent mechanism. FASEB J 1999; 13: 1435-1443
103. 104. Tiao G, Hobler S, Wang JJ, et al: Sepsis is associated with increased mRNAs of the ubiquitin-proteasome proteolytic pathway in human skeletal muscle. J Clin Invest 1997; 99:163-168 (Pubitemid 27053458)
104. 105. Voisin L, Breuillé D, Combaret L, et al: Muscle wasting in a rat model of long- lasting sepsis results from the activation of lysosomal, Ca2+ -activated, and ubiquitinproteasome proteolytic pathways. J Clin Invest 1996; 97:1610-1617 (Pubitemid 26105471)
105. 106. Di Giovanni S, Molon A, Broccolini A, et al: Constitutive activation of MAPK cascade in acute quadriplegic myopathy. Ann Neurol 2004; 55:195-206 (Pubitemid 38166996)
106. 107. Deem S, Lee CM, Curtis JR: Acquired neuromuscular disorders in the intensive care unit. Am J Respir Crit Care Med 2003; 168: 735-739 (Pubitemid 37188296)
107. 108. Hanson P, Dive A, Brucher JM, et al: Acute corticosteroid myopathy in intensive care patients. Muscle Nerve 1997; 20:1371-1380 (Pubitemid 27446864)
108. Zochodne DW, Ramsay DA: Acute quadriplegic myopathy. Neurology 1994; 44:988-989
109. Reid CL, Campbell IT, Little RA: Muscle wasting and energy balance in critical illness. Clin Nutr 2004; 23:273-280
110. Gruther W, Benesch T, Zorn C, et al: Muscle wasting in intensive care patients: ultrasound observation of the M. quadriceps femoris muscle layer. J Rehabil Med 2008; 40:185-189
111. Campbell IT, Watt T, Withers D, et al: Muscle thickness, measured with ultrasound, may be an indicator of lean tissue wasting in multiple organ failure in the presence of edema. Am J Clin Nutr 1995; 62:533-539
112. 113. Chen R: Electrophysiological studies in the critical care unit: Investigating polyneuropathies. Can J Neurol Sci 1998; 25:S32-S35 (Pubitemid 28123320)
113. 114. Herridge MS, Batt J, Hopkins RO: The pathophysiology of long-term neuromuscular and cognitive outcomes following critical illness. Crit Care Clin 2008; 24:179-199 (Pubitemid 351181259)
114. 115. Melli G, Chaudhry V, Cornblath DR: Rhabdomyolysis: An evaluation of 475 hospitalized patients. Medicine (Baltimore) 2005; 84:377-385 (Pubitemid 41668936)
115. 116. Ely EW, Shintani A, Truman B, et al: Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004; 291:1753-1762 (Pubitemid 38489897)
116. 117. Latronico N, Bertolini G, Guarneri B, et al: Simplified electrophysiological evaluation of peripheral nerves in critically ill patients: The Italian multi-centre CRIMYNE study. Crit Care 2007; 11:R11 (Pubitemid 46351114)
117. Sitwell LD, Weinshenker BG, Monpetit V, et al: Complete ophthalmoplegia as a complication of acute corticosteroid- and pancuronium-associated myopathy. Neurology 1991; 41:921-922
118. Coakley JH, Nagendran K, Ormerod IE, et al: Prolonged neurogenic weakness in patients requiring mechanical ventilation for acute airflow limitation. Chest 1992; 101: 1413-1416
119. 120. Young GB, Hammond RR: A stronger approach to weakness in the intensive care unit. Crit Care 2004; 8:416-418 (Pubitemid 40073669)
120. Hough CL, Steinberg KP, Taylor Thompson B, et al: Intensive care unit-acquired neuromyopathy and corticosteroids in survivors of persistent ARDS. Intensive Care Med 2009; 35:63-68. Epub 2008 Oct 23