부산대학교 도서관

Abstract Background Critical illness myopathy (CIM) is a consequence of modern critical care resulting in general muscle wasting and paralyses of all limb and trunk muscles, resulting in prolonged weaning from the ventilator, intensive care unit (ICU) treatment and rehabilitation. CIM is associated with severe morbidity/mortality and significant negative socioeconomic consequences, which has become increasingly evident during the current COVID‐19 pandemic, but underlying mechanisms remain elusive. Methods Ten neuro‐ICU patients exposed to long‐term controlled mechanical ventilation were followed with repeated muscle biopsies, electrophysiology and plasma collection three times per week for up to 12 days. Single muscle fibre contractile recordings were conducted on the first and final biopsy, and a multiomics approach was taken to analyse gene and protein expression in muscle and plasma at all collection time points. Results (i) A progressive preferential myosin loss, the hallmark of CIM, was observed in all neuro‐ICU patients during the observation period (myosin:actin ratio decreased from 2.0 in the first to 0.9 in the final biopsy, P 2) and activation of protein degradation pathways (false discovery rate [FDR] 65% during the 12 day observation period (muscle fibre cross‐sectional area [CSA] and maximum single muscle fibre force normalized to CSA [specific force] declined 30% [P