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Critical care myopathy — also known as myopathy of critical illness or intensive care unit (ICU) myopathy — is a syndrome that can occur in sick patients with complicated and prolonged ICU stays. Patients affected by this condition develop generalized weakness or an inability to move their muscles. Although some risk factors for developing the illness are known, the underlying cause of the condition is unclear. Diagnosis of the condition is made on the basis of clinical history of electromyography (EMG) testing. Treatment is supportive, and patients typically recover the function of their muscles slowly over time.
Symptoms of critical care myopathy include weakness and inability to move the muscles of the body. It often affects the muscles of the body diffusely, causing generalized weakness; typically, however, it does not affect the function of the facial muscles or of the muscles used to breathe. For a number of reasons, the illness is often not immediately recognized. First, many severely ill patients are given paralytic medications in order to prevent them from resisting mechanical breaths administered by a ventilator, and therefore weakness would not be evident. Second, critically ill patients often lie in bed for days at a time, and their muscles become weak from disuse and lack of physical activity.
There are a number of risk factors that increase a patient’s chance of developing critical care myopathy. Often patients who require mechanical ventilation for prolonged periods are at the greatest risk. Use of certain medications, including intravenous corticosteroids and medications used to paralyze patients, also increases the risk. Severe infections, including those that are so widespread that they can cause dysfunction of different organs of the body, also put patients at risk for developing this syndrome.
Diagnosing critical care myopathy can often be done on the basis of clinical history paired with the symptoms noted in the patients. Often, the diagnosis can be confirmed by performing a test known as electromyography (EMG). This test uses needles inserted into different muscles located throughout the body, and measures the electrical activity of the muscles as they move. Typically, the electrical signals are transmitted in a coordinated and consistent fashion. In the presence of critical care myopathy, however, the electrical activity is abnormal, displaying unregulated muscle activity.
Treatment of critical care myopathy is typically supportive. Patients’ underlying medical conditions are addressed in an attempt to optimize their overall health. When awake and alert, the patients can work with physical or occupational therapists, performing exercises to regain their strength. Often these patients may need to spend weeks in a rehabilitation facility until they are able to take care of themselves independently. No known medications or surgeries can help to cure this illness.
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