如果您无法下载资料，请参考说明：
1、部分资料下载需要金币，请确保您的账户上有足够的金币
2、已购买过的文档，再次下载不重复扣费
3、资料包下载后请先用软件解压，在使用对应软件打开
CRITICALILLNESSNEUROMYOPATHYAbbreviationsHISTORICALREVIEWStudiesaboutAetiologyvariouslyAdaptedwithpermissionfromBolton.AdaptedwithpermissionfromBolton25.Figure.3Schematic,theoreticalpresentationofdisturbancesinthemicrocirculationtovariousorgans,includingbrain,peripheralnerve,andmuscle,inSIRS.Incidence50%–70%SIRS20%–50%ICU•Weaknessoflimbandrespiratorymuscle•Tendonreflexesabsentordecrease•Distallosstopain,temperature,andvibrationThediagnosticcriteriaforCIPareshowninfollowingTableDeclineintheCMAPamplitudefirstly(Fig.4)DclineintheSNAPamplitudeMotorunitpotentialsmaybereducedinnumberSingle-fiberEMGindicatedysfunctionofterminalmotoraxonsMeasurementofcompoundthenarmuscleactionpotentialsattheonsetofsepsis(A)and3weekslater(B).Peripheralaxonaldegeneration.ModeratelossofdorsalrootganglioncellsCentralchromatolysisofanteriorhorncellsNoinflammationintheperipheralnervoussystemAxonalvariantsofGuillain–Barre′syndromeDevelopearlierOftenassociatedwithCJinfectionAbnormalcerebralspinalfluidTreatmentofsepsisandmultipleorgandysfunctionsyndromeManagementofdifficultyinweaningfromtheventilatorAttemptsatdirecttreatmentofCIP(stillunproven)PhysiotherapyandrehabilitationRecoverydependsonthedistanceRecoveryforweeksinmildcasesandmonthsinseverecasesSlowingofnerveconductionmayhaveapoorprognosisIncidenceAtleastone-thirdofICUpatients（treatedforstatusasthmaticus）In7%ofpatientsaftertransplantationDiagnosticcriteriaofCIM●SNAPamplitudes80%ofthelowerlimitofnormal●NeedleEMGwithshort-duration,low-amplitudeMUPswithearlyornormalfullrecruitment,withorwithoutfibrillationpotentials●AbsenceofadecrementalresponseonrepetitivenervestimulationNerveconductionstudiesLow-amplitudeCMAPsLongdurationCMAPsNormalSNAPsPhrenicnerveconductionnormallatenciesdiaphragmCMAPamplitudesreduceFeaturesofthehistopathologyinthickfilamentmyosinloss(Fig.5)Electronmicroscopyrevealsselectivelossofthick(myosin)filaments(Fig.6)InflammatorychangesareconspicuouslyabsentFigure.5Musc
立即下载
