Intensive care myopathy is a syndrome that causes weakness and muscle immobility in patients with prolonged stays in the ICU. Diagnosis is made through medical history and EMG tests, and treatment is supportive. Risk factors include prolonged mechanical ventilation and certain drugs.
Intensive care myopathy — also known as critical illness myopathy or intensive care unit (ICU) myopathy — is a syndrome that can occur in sick patients with complicated and prolonged stays in the ICU. Patients with this condition develop generalized weakness or the inability to move their muscles. While some risk factors for developing the disease are known, the underlying cause of the condition is unclear. The diagnosis of the condition is made on the basis of the medical history of the electromyography (EMG) test. Treatment is supportive, and patients generally recover muscle function slowly over time.
Symptoms of ICU myopathy include weakness and the inability to move muscles in the body. It often affects the muscles of the body in a diffuse way, causing generalized weakness; typically, however, it does not affect the function of the facial muscles or the muscles used to breathe. For a variety of reasons, the disease is often not recognized immediately. First, many seriously ill patients are given paralytic drugs to prevent them from resisting mechanical breaths delivered by a ventilator, and thus weakness would not be apparent. Second, critically ill patients often lie in bed for days and their muscles weaken due to disuse and lack of physical activity.
There are a number of risk factors that increase a patient’s chance of developing myopathy in the ICU. Often patients who require mechanical ventilation for prolonged periods are at increased risk. The use of some drugs, including intravenous corticosteroids and drugs used to paralyze patients, also increase the risk. Serious infections, including those so prevalent that they cause dysfunction of several organs in the body, also put patients at risk of developing this syndrome.
The diagnosis of ICU myopathy can often be made on the basis of the medical history associated with the symptoms noted in patients. Often, the diagnosis can be confirmed by doing a test known as an 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, electrical signals are transmitted in a coordinated and coherent manner. In the presence of ICU myopathy, however, the electrical activity is abnormal, showing unregulated muscle activity.
Treatment of myopathy in the ICU is typically supportive. Patients’ underlying medical conditions are addressed in an effort to optimize their overall health. When awake and alert, patients can work with physical or occupational therapists, performing exercises to regain strength. Often these patients may need to spend weeks in a rehabilitation facility until they are able to care for themselves independently. No known medications or surgeries can help cure this disease.
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