{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:04:03Z","timestamp":1783051443163,"version":"3.54.6"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2011,10,21]],"date-time":"2011-10-21T00:00:00Z","timestamp":1319155200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2011,10,21]],"date-time":"2011-10-21T00:00:00Z","timestamp":1319155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>This prospective study investigated whether plasma ionized calcium concentration abnormalities and other electrolyte disturbances represent risk factors for the development of critical illness polyneuromyopathy (CIPNM) in ICU patients.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>One hundred and ninety consecutive adult critically ill patients with prolonged ICU stay (longer than 7 days) were prospectively evaluated. Patients with acute weakness and\/or weaning difficulties were subjected to extensive electrophysiological measurements in order to establish the diagnosis of CIPNM. All recognized and\/or possible risk factors for development of CIPNM were recorded.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>The diagnosis of CIPNM was confirmed in 40 patients (21.05%). By applying a logistic regression model, hypocalcemia (<jats:italic>P<\/jats:italic> = 0.02), hypercalcemia (P = 0.01) and septic shock (<jats:italic>P<\/jats:italic> = 0.04) were independently associated with the development of CIPNM in critically ill patients.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>We found that septic shock and abnormal fluctuations of plasma Ca<jats:sup>2+<\/jats:sup> concentration represent significant risk factors for the development of CIPNM in critically ill patients.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc10505","type":"journal-article","created":{"date-parts":[[2011,12,3]],"date-time":"2011-12-03T03:04:57Z","timestamp":1322881497000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Is plasma calcium concentration implicated in the development of critical illness polyneuropathy and myopathy?"],"prefix":"10.1186","volume":"15","author":[{"given":"Dimitri","family":"Anastasopoulos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonios","family":"Kefaliakos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Argyris","family":"Michalopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2011,10,21]]},"reference":[{"key":"9760_CR1","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1111\/j.1468-1331.2006.01498.x","volume":"13","author":"LH Visser","year":"2006","unstructured":"Visser LH: Critical llness polyneuropathy and myopathy: clinical features, risk factors and prognosis.\n                           Eur J Neurol 2006, 13: 1203-1212. 10.1111\/j.1468-1331.2006.01498.x","journal-title":"Eur J Neurol"},{"key":"9760_CR2","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1002\/mus.20304","volume":"32","author":"CF Bolton","year":"2005","unstructured":"Bolton CF: Neuromuscular manifestations of critical illness.\n                           Muscle Nerve 2005, 32: 140-163. {Query: Ref 2 is now Ref 1 and Ref 1 became Ref 2} 10.1002\/mus.20304","journal-title":"Muscle Nerve"},{"key":"9760_CR3","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1212\/01.wnl.0000239826.63523.8e","volume":"67","author":"J Khan","year":"2006","unstructured":"Khan J, Harrison TB, Rich MM, Moss M: Early development of critical illness myopathy and neuropathy in patients with severe sepsis.\n                           Neurology 2006, 67: 1421-1425. 10.1212\/01.wnl.0000239826.63523.8e","journal-title":"Neurology"},{"key":"9760_CR4","doi-asserted-by":"publisher","first-page":"2281","DOI":"10.1097\/00003246-200112000-00008","volume":"29","author":"MA De Letter","year":"2001","unstructured":"De Letter MA, Schmitz PI, Visser LH, Verheul FA, Schellens RL, Op de Coul DA, Van der Meche FG: Risk factors for the development of polyneuropathy and myopathy in critically ill patients.\n                           Crit Care Med 2001, 29: 2281-2286. 10.1097\/00003246-200112000-00008","journal-title":"Crit Care Med"},{"key":"9760_CR5","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1007\/BF03022883","volume":"53","author":"MJ Murray","year":"2006","unstructured":"Murray MJ, Brull SJ, Bolton CF: Brief review: nondepolarizing neuromuscular blocking drugs and critical illness myopathy.\n                           Can J Anesth 2006, 53: 1148-1156. 10.1007\/BF03022883","journal-title":"Can J Anesth"},{"key":"9760_CR6","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1212\/01.WNL.0000158442.08857.FC","volume":"64","author":"G Van den Berghe","year":"2005","unstructured":"Van den Berghe G, Schoonheydt K, Becx P, Bruyninckx F, Wouters PJ: Insulin therapy protects the central and peripheral nervous system of intensive care patients.\n                           Neurology 2005, 64: 1348-1353. 10.1212\/01.WNL.0000158442.08857.FC","journal-title":"Neurology"},{"key":"9760_CR7","doi-asserted-by":"publisher","first-page":"R119","DOI":"10.1186\/cc9074","volume":"14","author":"S Weber-Carstens","year":"2010","unstructured":"Weber-Carstens S, Deja M, Koch S, Spranger J, Bubser F, Wernecke KD, Spies CD, Spuler S, Keh D: Risk factors in critical illness myopathy during the early course of critical illness: a prospective observational study.\n                           Crit Care 2010, 14: R119. 10.1186\/cc9074","journal-title":"Crit Care"},{"key":"9760_CR8","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1097\/CCM.0b013e318170aa97","volume":"36","author":"W Zink","year":"2008","unstructured":"Zink W, Kaess M, Hofer S, Plachky J, Zausig YA, Sinner B: Alterations in intracellular Ca\n                           \n                              2+\n                           \n                           -homeostasis of skeletal muscle fibers during sepsis.\n                           Crit Care Med 2008, 36: 1559-1563. 10.1097\/CCM.0b013e318170aa97","journal-title":"Crit Care Med"},{"key":"9760_CR9","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1046\/j.1399-6576.2003.00236.x","volume":"47","author":"J H\u00e4stbacka","year":"2003","unstructured":"H\u00e4stbacka J, Pettil\u00e4e V: Prevalence and predictive value of ionized hypocalcemia among critically ill patients.\n                           Muscle Acta Anaesthesiol Scand 2003, 47: 1264-1269. 10.1046\/j.1399-6576.2003.00236.x","journal-title":"Muscle Acta Anaesthesiol Scand"},{"key":"9760_CR10","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1007\/BF00441220","volume":"138","author":"K Kruse","year":"1982","unstructured":"Kruse K, Scheunemann W, Baier W, Schaub J: Hypocalcemic myopathy in idiopathic hypoparathyroidism.\n                           Eur J Pediatr 1982, 138: 280-282. 10.1007\/BF00441220","journal-title":"Eur J Pediatr"},{"key":"9760_CR11","volume-title":"J Endocrinol Invest","author":"C Dai","year":"2011","unstructured":"Dai C, Sun Z, Zhang X, Qiu M: Elevated muscle enzymes and muscle biopsy in idiopathic hypoparathyroidism patients.\n                           J Endocrinol Invest 2011, in press."},{"key":"9760_CR12","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1016\/S0887-8994(97)00210-5","volume":"18","author":"T Ishikawa","year":"1998","unstructured":"Ishikawa T, Kanayama M, Oba T, Horie T: Hypocalcemic induced increase in creatine kinase in rats.\n                           Pedr Neurol 1998, 18: 326-330. 10.1016\/S0887-8994(97)00210-5","journal-title":"Pedr Neurol"},{"key":"9760_CR13","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S0025-7125(16)30282-6","volume":"77","author":"DR Tonner","year":"1993","unstructured":"Tonner DR, Schlechte JA: Neurologic complications of thyroid and parathyroid disease.\n                           Med Clin North Am 1993, 77: 251-263.","journal-title":"Med Clin North Am"},{"key":"9760_CR14","volume-title":"Aids to Examination of the Peripheral Nervous System","author":"Medical Research Council","year":"1976","unstructured":"Medical Research Council: Aids to Examination of the Peripheral Nervous System. London: Her Majesty's Stationary Office; 1976. Memorandum No 45"},{"key":"9760_CR15","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1097\/CCM.0b013e3181b6ef67","volume":"37","author":"RD Stevens","year":"2009","unstructured":"Stevens RD, Marshall SA, Cornblath DR, Hoke A, Needham DM, de Jonghe B, et al.: A framework for diagnosing and classifying intensive care unit-acquired weakness.\n                           Crit Care Med 2009, 37: 299-308.","journal-title":"Crit Care Med"},{"key":"9760_CR16","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1007\/s001340101009","volume":"27","author":"J Garnacho-Montero","year":"2001","unstructured":"Garnacho-Montero J, Madrazo-Osuna J, Garcia-Garmendia J: Critical illness polyneuropathy: risk factors and clinical consequences. A cohort study in septic patients.\n                           Intensive Care Med 2001, 27: 1288-1296. 10.1007\/s001340101009","journal-title":"Intensive Care Med"},{"key":"9760_CR17","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1161\/01.CIR.95.7.1783","volume":"95","author":"D Giugliano","year":"1997","unstructured":"Giugliano D, Marfella R, Coppola L, Verazzo G, Acampora R, Giunta R, Nappo F, Lucarelli C, D Onofrio F: Vascular effects of acute hyperglycemia in humans are reversed by l-arginine. Evidence for reduced availability of nitric oxide during hyperglycemia.\n                           Circulation 1997, 95: 1783-1790.","journal-title":"Circulation"},{"key":"9760_CR18","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1097\/00003246-199711000-00014","volume":"25","author":"DJ Muckart","year":"1997","unstructured":"Muckart DJ, Bhagwanjee S: American College of Chest Physicians\/Society of Critical Care Medicine Consensus Conference definitions of the systemic inflammatory response syndrome and allied disorders in relation to critically injured patients.\n                           Crit Care Med 1997, 25: 1789-1795. 10.1097\/00003246-199711000-00014","journal-title":"Crit Care Med"},{"key":"9760_CR19","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1016\/S0272-6386(01)80116-5","volume":"37","author":"JR Zivin","year":"2001","unstructured":"Zivin JR, Gooley T, Zager RA, Ryan MJ: Hypocalcemia: a pervasive metabolic abnormality in the critically ill.\n                           Am J Kidney Dis 2001, 37: 689-698. 10.1016\/S0272-6386(01)80116-5","journal-title":"Am J Kidney Dis"},{"key":"9760_CR20","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1097\/00003246-199302000-00009","volume":"21","author":"GP Zaloga","year":"1993","unstructured":"Zaloga GP, Washburn D, Black KW, Prielipp R: Human sepsis increases lymphocyte intracellular calcium.\n                           Crit Care Med 1993, 21: 196-202. 10.1097\/00003246-199302000-00009","journal-title":"Crit Care Med"},{"key":"9760_CR21","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1096\/fasebj.13.11.1435","volume":"13","author":"AB Williams","year":"1999","unstructured":"Williams AB, Decourten-Myers GM, Fischer JE, Luo G, Sun X, Hasselgren PO: Sepsis stimulates release of myofilaments in skeletal muscle by a calcium-dependent mechanism.\n                           FASEB J 1999, 13: 1435-1443.","journal-title":"FASEB J"},{"key":"9760_CR22","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1097\/01.CCM.0000254335.88023.0E","volume":"35","author":"B Rossignol","year":"2007","unstructured":"Rossignol B, Gueret G, Pennec JP, Morel J, Giroux-Metges MA, Talarmin H: Effects of chronic sepsis on the voltage-gated sodium channel in isolated rat muscle fibers.\n                           Crit Care Med 2007, 35: 351-357. 10.1097\/01.CCM.0000254335.88023.0E","journal-title":"Crit Care Med"},{"key":"9760_CR23","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1113\/jphysiol.1957.sp005808","volume":"137","author":"B Frankenhaeser","year":"1957","unstructured":"Frankenhaeser B, Hodgkin AL: The action of calcium on the electrical properties of squid axons.\n                           J Physiol 1957, 137: 218-244.","journal-title":"J Physiol"},{"key":"9760_CR24","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1016\/j.neuron.2010.09.014","volume":"68","author":"B Lu","year":"2010","unstructured":"Lu B, Zhang Q, Wang H, Wang Y, Nakayama M, Ren D: Extracellular calcium controls background current and neuronal excitability via an UNC79-UNC80-NALCN cation channel complex.\n                           Neuron 2010, 68: 488-499. 10.1016\/j.neuron.2010.09.014","journal-title":"Neuron"},{"key":"9760_CR25","first-page":"e68","volume":"10","author":"Q Chan","year":"2010","unstructured":"Chan Q, Ng K, Vandervord J: Critical illness polyneuropathy in patients with major burn injuries.\n                           Eplasty 2010, 10: e68.","journal-title":"Eplasty"},{"key":"9760_CR26","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1111\/j.1399-6576.2009.01952.x","volume":"53","author":"K Ahlbeck","year":"2009","unstructured":"Ahlbeck K, Fredriksson K, Rooyackers O, M\u00e5b\u00e4ck G, Remahl S, Ansved T, Eriksson L, Radell P: Signs of critical illness polyneuropathy and myopathy can be seen early in the ICU course.\n                           Acta Anaesthesiol Scand 2009, 53: 717-723. 10.1111\/j.1399-6576.2009.01952.x","journal-title":"Acta Anaesthesiol Scand"},{"key":"9760_CR27","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1111\/j.1600-0404.2008.00996.x","volume":"118","author":"S Nanas","year":"2008","unstructured":"Nanas S, Kritikos K, Angelopoulos E, Siafaka A, Tsikriki S, Poriazi M, Kanaloupiti D, Kontogeorgi M, Pratikaki M, Zervakis D, Routsi C, Roussos C: Predisposing factors for critical illness polyneuromyopathy in a multidisciplinary intensive care unit.\n                           Acta Neurol Scand 2008, 118: 175-181. 10.1111\/j.1600-0404.2008.00996.x","journal-title":"Acta Neurol Scand"},{"key":"9760_CR28","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s11940-007-0034-1","volume":"9","author":"SJ Bird","year":"2007","unstructured":"Bird SJ: Diagnosis and management of critical illness polyneuropathy and critical illness myopathy.\n                           Curr Treat Options Neurol 2007, 9: 85-92. 10.1007\/s11940-007-0034-1","journal-title":"Curr Treat Options Neurol"},{"key":"9760_CR29","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1002\/ana.410430207","volume":"43","author":"MM Rich","year":"1998","unstructured":"Rich MM, Pinter MJ, Kraner SD, Barchi RL: Loss of electrical excitability in an animal model of acute quadriplegic myopathy.\n                           Ann Neurol 1998, 43: 171-179. 10.1002\/ana.410430207","journal-title":"Ann Neurol"},{"key":"9760_CR30","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1002\/ana.1016","volume":"50","author":"MM Rich","year":"2001","unstructured":"Rich MM, Pinter MJ: Sodium channel inactivation in an animal model of acute quadriplegic myopathy.\n                           Ann Neurol 2001, 50: 26-33. 10.1002\/ana.1016","journal-title":"Ann Neurol"},{"key":"9760_CR31","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1016\/j.clinph.2010.09.024","volume":"122","author":"WJ Z'Graggen","year":"2011","unstructured":"Z'Graggen WJ, Brander L, Tuchscherer D, Scheidegger O, Takala J, Bostock H: Muscle membrane dysfuction in critical illness myopathy assessed by velocity recovery cycles.\n                           Clin Neurophysiol 2011, 122: 834-841. 10.1016\/j.clinph.2010.09.024","journal-title":"Clin Neurophysiol"},{"key":"9760_CR32","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1002\/(SICI)1098-2388(199703\/04)13:2<104::AID-SSU6>3.0.CO;2-D","volume":"13","author":"G Akerstr\u00f6m","year":"1997","unstructured":"Akerstr\u00f6m G: Non-familial primary hypoparathyroidism.\n                           Semin Surg Oncol 1997, 13: 104-113. 10.1002\/(SICI)1098-2388(199703\/04)13:2<104::AID-SSU6>3.0.CO;2-D","journal-title":"Semin Surg Oncol"},{"key":"9760_CR33","doi-asserted-by":"crossref","first-page":"74","DOI":"10.5694\/j.1326-5377.1988.tb120508.x","volume":"149","author":"LW Delbridge","year":"1988","unstructured":"Delbridge LW, Marshman D, Reeve TS, Crummer P, Posen S: >Neuromuscular symptoms in elderly patients with hyperparathyroidism: improvement with parathyroid surgery.\n                           Med J Aust 1988, 149: 74-76.","journal-title":"Med J Aust"}],"container-title":["Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/cc10505.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/cc10505\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/cc10505.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:33:52Z","timestamp":1728304432000},"score":1,"resource":{"primary":{"URL":"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/cc10505"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,10,21]]},"references-count":33,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2011,10]]}},"alternative-id":["9760"],"URL":"https:\/\/doi.org\/10.1186\/cc10505","relation":{},"ISSN":["1364-8535"],"issn-type":[{"value":"1364-8535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,10,21]]},"assertion":[{"value":"23 May 2011","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 September 2011","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 October 2011","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 October 2011","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"R247"}}