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Critical illness myopathy.

David Lacomis¹

¹University of Pittsburgh Medical Center Presbyterian, 200 Lothrop Street, F878, Pittsburgh, PA 15213, USA. lacomis@np.awing.upmc.edu

Current Rheumatology Reports

|September 10, 2002

Summary

This summary is machine-generated.

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Critical illness myopathy, common in ICUs, causes weakness and ventilation failure. It involves muscle excitability loss and protein changes, but is reversible.

Area of Science:

Critical care medicine
Neuromuscular disorders

Background:

Acute myopathy is a frequent complication in intensive care units (ICUs).
Patients at high risk often receive intravenous corticosteroids and paralytic agents.
Clinical signs include diffuse weakness and difficulty weaning from mechanical ventilation.

Purpose of the Study:

To review the pathophysiology and clinical features of critical illness myopathy.
To discuss diagnostic findings and potential mechanisms.
To highlight the reversibility and morbidity associated with this condition.

Main Methods:

Review of existing literature on critical illness myopathy.
Analysis of clinical manifestations, electrodiagnostic findings, and pathological studies.
Inclusion of insights from animal models.

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Main Results:

Electrodiagnostic studies show a myopathic process with muscle membrane inexcitability.
Pathology reveals myosin loss with preserved structural proteins.
Mechanisms may involve sodium channel inactivation, proteolytic pathway activation (calpain, ubiquitin), and apoptosis.

Conclusions:

Critical illness myopathy is characterized by muscle weakness and impaired excitability.
While reversible, it can lead to significant patient morbidity.
Understanding the underlying mechanisms is crucial for management.