Critical illness myopathy is frequent – accompanying neuropathy protracts ICU discharge

Overview & Synopsis

Objectives: Neuromuscular dysfunction in critically ill patients is attributed to either critical illness myopathy (CIM) or critical illness polyneuropathy (CIP) or a combination of both. But it is unknown whether differential diagnosis has an impact on prognosis. This study investigates whether there is an association between the early differentiation of CIM versus CIP and clinical prognosis. Methods: We included mechanically ventilated patients who featured a Simplified Acute Physiology Score II (SAPS-II) ≥ 20 on three consecutive days within the first week after ICU admission. 53 critically ill patients were enrolled and examined by conventional nerve conduction studies and direct muscle stimulation (184 examinations in total). The first examination was conducted within the first week after admission to the intensive care unit (ICU). Results: In this cohort of critically ill patients, CIM was more frequent (68%) than CIP (38%). Electrophysiological signs of CIM preceded electrophysiological signs of CIP (median at day 7 in CIM patients vs. day 10 in CIP patients, p