Intensive Care Medicine

, Volume 35, Issue 1, pp 63–68

Intensive care unit-acquired neuromyopathy and corticosteroids in survivors of persistent ARDS

  • Catherine L. Hough
  • Kenneth P. Steinberg
  • B. Taylor Thompson
  • Gordon D. Rubenfeld
  • Leonard D. Hudson
Original

DOI: 10.1007/s00134-008-1304-4

Cite this article as:
Hough, C.L., Steinberg, K.P., Taylor Thompson, B. et al. Intensive Care Med (2009) 35: 63. doi:10.1007/s00134-008-1304-4

Abstract

Objectives

To determine the incidence and outcomes of intensive care unit-acquired neuromyopathy and to investigate the role of methylprednisolone in survivors of persistent acute lung injury.

Design

Secondary analysis of completed randomized placebo-controlled trial.

Setting

Twenty-five hospitals in the NHLBI ARDS Network.

Patients and participants

Patients enrolled in the ARDS Network study of methylprednisolone versus placebo for persistent ARDS who survived 60 days or to hospital discharge.

Measurements and results

One hundred and twenty-eight study patients survived 60 days. Forty-three (34%) of these patients had evidence by chart review of ICU-acquired neuromyopathy, which was associated with prolonged mechanical ventilation, return to mechanical ventilation, and delayed return to home after critical illness. Treatment with methylprednisolone was not significantly associated with an increase in risk of neuromyopathy (OR 1.5; 95% CI 0.7–3.2).

Conclusions

ICU-acquired-neuromyopathy is common among survivors of persistent ARDS and is associated with poorer clinical outcomes. We did not find a significant association between methylprednisolone treatment and neuromyopathy. Limitations of this study preclude definitive conclusions about the causal relationship between corticosteroids and ICU-acquired neuromuscular dysfunction.

Keywords

Acute lung injuryAcute respiratory distress syndromeCritical illnessGlucocorticoids/therapeutic useParesisCritical illness polyneuropathy

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Catherine L. Hough
    • 1
  • Kenneth P. Steinberg
    • 1
  • B. Taylor Thompson
    • 2
  • Gordon D. Rubenfeld
    • 3
  • Leonard D. Hudson
    • 1
  1. 1.Department of Medicine and The NHLBI ARDS NetworkUniversity of WashingtonSeattleUSA
  2. 2.Department of Medicine and The NHLBI ARDS NetworkMassachusetts General HospitalBostonUSA
  3. 3.Department of MedicineUniversity of TorontoTorontoCanada