Koch Susanne, Wollersheim Tobias, Bierbrauer Jeffrey, Haas Kurt, Mörgeli Rudolf, Deja Maria, Spies Claudia D, Spuler Simone, Krebs Martin, Weber-Carstens Steffen
Department of Anesthesiology and Intensive Care Medicine, Campus Virchow-Klinikum and Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Muscle Nerve. 2014 Sep;50(3):431-6. doi: 10.1002/mus.24175. Epub 2014 Jul 14.
Muscle weakness in critically ill patients after discharge varies. It is not known whether the electrophysiological distinction between critical illness myopathy (CIM) and critical illness polyneuropathy (CIP) during the early part of a patient's stay in the intensive care unit (ICU) predicts long-term prognosis.
This was a prospective cohort study of mechanically ventilated ICU patients undergoing conventional nerve conduction studies and direct muscle stimulation in addition to neurological examination during their ICU stay and 1 year after ICU discharge.
Twenty-six patients (7 ICU controls, 8 CIM patients, and 11 CIM/CIP patients) were evaluated 1 year after discharge from the ICU. Eighty-eight percent (n = 7) of CIM patients recovered within 1 year compared with 55% (n = 6) of CIM/CIP patients. Thirty-six percent (n = 4) of CIM/CIP patients still needed assistance during their daily routine (P = 0.005).
Early electrophysiological testing predicts long-term outcome in ICU survivors. CIM has a significantly better prognosis than CIM/CIP.
危重症患者出院后的肌无力情况各不相同。目前尚不清楚患者在重症监护病房（ICU）住院早期，危重症性肌病（CIM）和危重症性多发性神经病（CIP）之间的电生理差异是否能预测长期预后。
这是一项前瞻性队列研究，对接受机械通气的ICU患者在其ICU住院期间及出院后1年进行常规神经传导研究、直接肌肉刺激以及神经学检查。
26例患者（7例ICU对照、8例CIM患者和11例CIM/CIP患者）在ICU出院1年后接受评估。88%（n = 7）的CIM患者在1年内康复，而CIM/CIP患者的这一比例为55%（n = 6）。36%（n = 4）的CIM/CIP患者在日常生活中仍需要帮助（P = 0.005）。
早期电生理测试可预测ICU幸存者的长期预后。CIM的预后明显优于CIM/CIP。
