Long-term recovery In critical illness myopathy is complete, contrary to polyneuropathy

Muscle Nerve. 2014 Sep;50(3):431-6. doi: 10.1002/mus.24175. Epub 2014 Jul 14.


Introduction: Muscle weakness in critically ill patients after discharge varies. It is not known whether the electrophysiological distinction between critical illness myopathy (CIM) and critical illness polyneuropathy (CIP) during the early part of a patient's stay in the intensive care unit (ICU) predicts long-term prognosis.

Methods: This was a prospective cohort study of mechanically ventilated ICU patients undergoing conventional nerve conduction studies and direct muscle stimulation in addition to neurological examination during their ICU stay and 1 year after ICU discharge.

Results: Twenty-six patients (7 ICU controls, 8 CIM patients, and 11 CIM/CIP patients) were evaluated 1 year after discharge from the ICU. Eighty-eight percent (n = 7) of CIM patients recovered within 1 year compared with 55% (n = 6) of CIM/CIP patients. Thirty-six percent (n = 4) of CIM/CIP patients still needed assistance during their daily routine (P = 0.005).

Conclusions: Early electrophysiological testing predicts long-term outcome in ICU survivors. CIM has a significantly better prognosis than CIM/CIP.

Keywords: critical illness myopathy; critical illness polyneuropathy; direct muscle stimulation; intensive care unit; long-term outcome.

MeSH terms

  • Action Potentials / physiology
  • Adolescent
  • Adult
  • Aged
  • Critical Illness / therapy*
  • Electrodiagnosis
  • Electrophysiology
  • Female
  • Follow-Up Studies
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Multiple Organ Failure / physiopathology
  • Muscle Contraction / physiology
  • Muscle Strength / physiology
  • Muscle, Skeletal / physiopathology
  • Muscular Diseases / therapy*
  • Neural Conduction
  • Neurologic Examination
  • Polyneuropathies / therapy*
  • Recovery of Function
  • Sepsis / complications
  • Treatment Outcome
  • Young Adult