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_name

Crit Care Med

journal_title

Critical care medicine

authors

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

doi

10.1097/CCM.0B013E3181659669

subject

Has Abstract

pub_date

2008-03-01 00:00:00

pages

910-6

issue

3

eissn

0090-3493

issn

1530-0293

pii

00003246-200803000-00035

journal_volume

36

pub_type

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