Critical Illness Myopathy


Critical Illness Myopathy, Myopathy Following ICU Admission

  • Risk Factors
  • Impacts mobility and stair climbing after ICU admit
  1. Prolonged ICU Stay
  2. Poor baseline health status
  3. Longer duration of Mechanical Ventilation
  • Pathophysiology
  1. Similar pathophysiology to Critical Illness Polyneuropathy
  2. Muscular deconditioning due to prolonged immobilization
  3. Myosin to Actin ratio reduced
  4. Lean Body Mass drops 2% per day with prolonged immobilization
  • Diagnosis
  1. Similar diagnostic criteria for Critical Illness Polyneuropathy
  2. Limb Weakness AND
  3. Unexplained difficult mechanical Ventilator Weaning
  • Diagnostics
  1. Distinguish from Critical Illness Polyneuropathy
    1. Electromyography
    2. Nerve Conduction Velocity Studies
  2. Distinguish from other Myopathy
    1. Muscle Biopsy
  • Management
  1. Physical Rehabilitation
    1. Contrast with Critical Illness Polyneuropathy in which physical therapy has no evidence of benefit
  2. Graded Exercise program
    1. Early mobilization is key
  • Course
  1. Complications associated with deconditioning can persist 12 months after ICU admission