期刊
MUSCLE & NERVE
卷 52, 期 1, 页码 28-33出版社
WILEY
DOI: 10.1002/mus.24489
关键词
critical illness; small fibers; polyneuropathy; myopathy; skin biopsy
资金
- Central European Institute of Technology, a project of the European Regional Development Fund [CZ.1.05/1.1.00/02.0068]
- Ministry of Health of the Czech Republic [65269705]
- Masaryk University [MUNI/A/0935/2013]
Introduction: Small-fiber pathology can develop in the acute phase of critical illness and may explain chronic sensory impairment and pain in critical care survivors. Methods: Eleven adult ischemic stroke patients in a neurocritical care unit were enrolled in an observational cohort study. Intraepidermal nerve fiber density (IENFD) in the distal leg was assessed on admission to the intensive care unit and 10-14 days later, together with electrophysiological testing. Results: Of the 11 patients recruited, 9 (82%) had sepsis or multiple-organ failure. Median IENFD on admission (5.05 fibers/mm) decreased significantly to 2.18 fibers/mm (P < 0.001), and abnormal IENFD was found in 6 patients (54.5%). Electrodiagnostic signs of large-fiber neuropathy and/or myopathy were found in 6 patients (54.5%), and autonomic dysfunction was found in 2 patients (18.2%). Conclusion: Serial IENFD measurements confirmed the development of small-fiber sensory involvement in the acute phase of critical illness.
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