Abstract
Objective
To estimate the incidence and nature of neuromuscular abnormalities in a representative group of ITU patients.
Design
Prospective sequential study.
Setting
Teaching hospital ITU.
Patients
23 patients who eventually stayed >7 days on ITU who had no contraindication to muscle biopsy and whose relatives gave informed consent.
Measurements and results
Muscle histopathology, neurophysiological studies, record of all drugs administered, APACHE II score, organ system failure score, presence or absence of sepsis, clinical evaluation of neuromuscular problems, time to hospital discharge. Heterogeneous neuromuscular abnormalities were present in 22 out of 23 patients studied and included axonal neuropathy, denervation, generalised fibre atrophy, non-specific myopathy and necrotising myopathy.
Conclusion
Neuromuscular abnormalities are almost invariable in longstay intensive care patients and the resulting weakness may seriously delay hospital discharge. Various abnormalities were seen but no obvious aetiological factors were identified. The origin of the abnormalities is probably multifactorial.
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This study was carried out with financial assistance from the Joint Research Board of St. Bartholomew's Hospital, the Locally Organised Research Scheme of North East Thames Regional Health Authority, and the excellent technical assistance of Miss Fiona Withey and Miss Joanna Wood.
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Coakley, J.H., Nagendran, K., Honavar, M. et al. Preliminary observations on the neuromuscular abnormalities in patients with organ failure and sepsis. Intensive Care Med 19, 323–328 (1993). https://doi.org/10.1007/BF01694705
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DOI: https://doi.org/10.1007/BF01694705