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Long-term outcome in patients with critical illness myopathy or neuropathy: the Italian multicentre CRIMYNE study
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  1. B Guarneri1,
  2. G Bertolini2,
  3. N Latronico3
  1. 1
    Department of Neuroscience, Section of Clinical Neurophysiology, University of Brescia, Spedali Civili, Italy
  2. 2
    Laboratory of Clinical Epidemiology, Aldo e Cele Daccò Clinical Research Centre, Mario Negri Institute, Ranica (Bergamo), Italy
  3. 3
    Department of Anaesthesia–Intensive Care Medicine, Section of Neuroanestesia and Neurocritical Care, University of Brescia, Spedali Civili, Italy
  1. Professor N Latronico, Department of Anesthesiology–Intensive Care, Section of Neuroanestesia and Neurocritical Care, University of Brescia, Piazzale Spedali Civili, 1-25125 Brescia, Italy; latronic{at}med.unibs.it

Abstract

Background: Critical illness myopathy (CIM) and polyneuropathy (CIP), alone or in combination (CIP/CIM), are frequent complications in patients in the intensive care unit (ICU). There is no evidence that differentiating between CIP and CIM has any impact on patient prognosis.

Methods: 1-year prospective cohort study of patients developing CIP, CIM or combined CIP and CIM during ICU stay.

Results: 28 out of 92 (30.4%) patients developed electrophysiological signs of CIP and/or CIM during their ICU stay, which persisted in 18 patients at ICU discharge. At hospital discharge, diagnoses in the 15 survivors were CIM in six cases, CIP in four, combined CIP and CIM in three and undetermined in two uncooperative patients. During the 1-year follow-up of six patients with CIM, one patient died and five recovered completely within 3 (three patients) to 6 (two patients) months. Of three patients with CIP/CIM, one died, one recovered and one with residual CIP remained tetraplegic. Of four patients with CIP, one recovered, two had persisting muscle weakness and one remained tetraparetic.

Conclusion: CIM has a better prognosis than CIP. Differential diagnosis is important to predict long-term outcome in ICU patients.

https://doi.org/10.1136/jnnp.2007.142430

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    Footnotes

    • Competing interests: GB and NL are part of the Steering Committee of the GiViTI (Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva), which is the recipient of an unconditional grant from AstraZeneca Italia SpA (Basiglio, Italy), Sanofi-Aventis (Paris, France) and Draeger Italia (Corsico, Italy). The other authors declare that they have no competing interests.

    • Ethics approval: Ethics approval was obtained.