Symptoms of critical care myopathy include weakness and inability to move the muscles of the body. It often affects the muscles of the body diffusely, causing generalized weakness; typically, however, it does not affect the function of the facial muscles or of the muscles used to breathe. For a number of reasons, the illness is often not immediately recognized. First, many severely ill patients are given paralytic medications in order to prevent them from resisting mechanical breaths administered by a ventilator, and therefore weakness would not be evident. Second, critically ill patients often lie in bed for days at a time, and their muscles become weak from disuse and lack of physical activity.

There are a number of risk factors that increase a patient's chance of developing critical care myopathy. Often patients who require mechanical ventilation for prolonged periods are at the greatest risk. Use of certain medications, including intravenous corticosteroids and medications used to paralyze patients, also increases the risk. Severe infections, including those that are so widespread that they can cause dysfunction of different organs of the body, also put patients at risk for developing this syndrome.

Diagnosing critical care myopathy can often be done on the basis of clinical history paired with the symptoms noted in the patients. Often, the diagnosis can be confirmed by performing a test known as electromyography (EMG). This test uses needles inserted into different muscles located throughout the body, and measures the electrical activity of the muscles as they move. Typically, the electrical signals are transmitted in a coordinated and consistent fashion. In the presence of critical care myopathy, however, the electrical activity is abnormal, displaying unregulated muscle activity.

Treatment of critical care myopathy is typically supportive. Patients’ underlying medical conditions are addressed in an attempt to optimize their overall health. When awake and alert, the patients can work with physical or occupational therapists, performing exercises to regain their strength. Often these patients may need to spend weeks in a rehabilitation facility until they are able to take care of themselves independently. No known medications or surgeries can help to cure this illness.

Critical Care Prevention:

The Discipline
Critical care medicine encompasses the diagnosis and treatment of a wide variety of clinical problems representing the extreme of human disease. Critically ill patients require intensive care by a coordinated team. The critical care specialist (sometimes referred to as an "intensivist") may be the primary provider of care or a consultant. The intensivist needs to be competent not only in a broad range of conditions common among critically ill patients but also with the technological procedures and devices used in intensive care settings. The care of critically ill patients also raises many complicated ethical and social issues, and the intensivist must be competent in areas such as end-of-life decisions, advance directives, estimating prognosis, and counseling of patients and their families.
Most physicians trained in critical care medicine work in hospital-based settings, usually in intensive care units. Within internal medicine, critical care medicine training is most commonly coupled with a pulmonary medicine fellowship since pulmonologists frequently oversee care of patients in intensive care units. However, other internal medicine physicians, such as cardiologists and general internists practicing hospital medicine, may seek training in critical care medicine to facilitate their work with severely ill patients.

Training
When combined with subspecialty training in pulmonary medicine (pulmonary and critical care medicine), a three year fellowship is required after which the trainee is eligible for subspecialty certification in both pulmonary medicine and critical care medicine.
For other internal medicine physicians, different routes of training in critical care medicine are available:

1. A two-year accredited fellowship in critical care medicine after the internal medicine residency.

2. Two years of fellowship training in advanced general internal medicine (that include at least six months of critical care medicine) plus one year of accredited fellowship training in critical care medicine.

3. Two years of accredited fellowship training in a subspecialty of internal medicine (three years for cardiovascular disease or gastrointestinal disease) plus one year of accredited clinical fellowship training in critical care medicine.

Certification in critical care medicine is jointly administered by the American Board of Internal Medicine, the American Board of Surgery, the American Board of Pediatrics, and the American Board of Anesthesiology.