JUST a week in intensive care can lead to lifelong muscle weakness that can hinder normal living, a new study warned.

When patients are bedbound for long periods, inactive and on a ventilator, they suffer from sustained muscle atrophy, which is loss of muscle mass and function.

Yet while some regain their muscle strength and function, others do not.

Canadian researchers said they traded critical illness for a new and potentially debilitating condition dubbed intensive care unit-acquired weakness.

This is when patients fail to regrow muscle and remain weak, which can last for the rest of their life.

Assistant Professor Dr Jane Batt said: “You may not be able to bathe yourself, feed yourself, go to the toilet yourself, dress yourself. This can be a very difficult life to live.

“We know ICU patients lose muscle mass and function. Critical illness literally causes their muscles to dissolve.

“Some people grow it back and some don’t. 

“Some people can regrow the muscle, but it doesn’t function properly.”

Until now little research has been conducted into the cellular and molecular mechanisms responsible for recovering muscle strength over the long-term.
The study by St Michael’s Hospital in Toronto found that some patients who continue to suffer from weakness six months after discharge, demonstrated persistent muscle wasting.

This was even when the biological functions that commonly cause muscles to atrophy have returned to normal, such as inflammation or the breakdown of proteins in muscle tissue.

Even patients who regrew muscle remained weak, which lead to profound disability and reduced quality of life. The respirologist added the novel finding of the study was that muscle atrophy in the long term is the result of impaired regrowth and is associated with a decrease in the number of satellite cells, the precursors to muscle cells.

She said: “While satellite cells are not required for existing muscle fibres to grow in size, they are essential for the regeneration of injured muscle.”
Decreased number of satellite cells also contributes to age-related muscle loss, she noted.

“Critical illness appears to permanently change muscle biology so your regenerative capacity seems to be lost,” she said.

The study examined critically ill patients who had spent at least one week on a ventilator in an ICU as the first phase of the MEND ICU research programme.

It is part of the RECOVER program, a multi-centre study that evaluates patient and caregiver outcomes after prolonged mechanical ventilation with a goal of developing a family-centred rehabilitation program after severe critical illness.