tailieunhanh - Báo cáo y học: "Hyperglycemia and acquired weakness in critically ill patients: potential mechanisms"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Hyperglycemia and acquired weakness in critically ill patients: potential mechanisms. | Available online http content 13 2 125 Commentary Hyperglycemia and acquired weakness in critically ill patients potential mechanisms Leigh Ann Callahan and Gerald S Supinski Division of Pulmonary Critical Care and Sleep Medicine Department of Internal Medicine University of Kentucky L543 Kentucky Clinic 740 South Limestone Lexington KY40536 USA Correspondence Leigh Ann Callahan lacall2@ See related research by Hermans et al. http content 13 1 R5 Published 26 March 2009 This article is online at http content 13 2 125 2009 BioMed Central Ltd Critical Care 2009 13 125 doi cc7728 Abstract Critical illness polyneuropathy critical illness myopathy CIP CIM is a major cause of mortality and long-term morbidity in critically ill patients but the true incidence and prevalence of these syndromes are not known. Hermans and colleagues show that when intensive insulin therapy is used as part of routine clinical practice in the intensive care unit the incidence of CIP CIM as determined by electrophysiologic testing is reduced. Our understanding of the mechanisms responsible for inducing prolonged weakness in intensive care unit patients is limited and the role of hyperglycemia in modulating these processes is unknown. Intensive insulin therapy currently remains the only effective therapeutic intervention that has been shown to reduce the incidence of CIP CIM. In a recent issue of Critical Care Hermans and colleagues showed that intensive insulin therapy IIT significantly reduces the incidence of electrophysiologic detection of neuromuscular complications in critically ill patients 1 . These findings are consistent with data obtained from two randomized controlled trials using IIT 2 3 which showed that IIT decreases the incidence of critical illness poly-neuropathy critical illness myopathy CIP CIM diagnosed by electroneuromyography as well as reducing the duration of mechanical ventilation and shortening the length of stay