Question
What is critical illness myopathy and what does it have to do with tracheostomy and ventilation?
Answer
Critical illness myopathy may occur in a medically complex patient who remains absent from functional activity for an extended period. This patient no longer has the resistance throughout the day needed to build their muscles. 62% of people who become ventilator-dependent begin to have some level of neuromuscular weakness (Shepherd et al., 2016). The reason the SLP needs to be aware of the high incidence of critical illness myopathy in the tracheostomy and ventilator dependent population is that the weakness is often widespread, substantial, and not limited to areas of the body that are below the neck. Lingual, labial, laryngeal, and pharyngeal function is often impacted by critical illness myopathy, causing significant issues with speaking and swallowing. This may lead to increased dependence and higher risks involved with introducing food and liquid; not only because of the high risk of aspiration but also because that aspiration may be more likely to result in a subsequent infection (Langmore et al., 1998 and 2002).
