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New weakness in a critically ill patient
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  1. C D SHEE
  1. Department of Medicine, Queen Mary's Sidcup NHS Trust, Sidcup, Kent DA14 6LT, UK

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    Sir,In a paper published in the May issue of your Journal, the authors describe a patient who was ventilated for acute severe asthma and who subsequently developed a profound weakness thought to be due to a myopathy.1 The authors attribute this to ‘critical illness myopathy’, and although in the discussion they mention that corticosteroids might have played a role in previous cases, they do not discuss whether this may have been a contributory factor in their own patient.

    The patient was originally treated with intravenous hydrocortisone 800 mg/day, increased to 2.4 g/day when the patient was transferred to the Intensive Care Unit, although the authors do not state for how long the patient received this dose. I have previously described four similar patients who developed a …

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