Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: We agree with Dr Latronico that the
occurrence of simultaneous axon and muscle involvement in critical illness
neuromuscular abnormalities (CINMA) is not novel. This finding has been previously
identified in 2 prospective cohort studies of ICU patients with systematic
electrophysiological and muscle histological examination.1,2 In
our study, electrophysiological examination and muscle biopsy were only performed
in patients with clinical paresis at awakening after the acute phase of their
illness, which confirmed that clinical weakness was associated with both axonal
and muscle involvement.
De Jonghe B, Outin H, Sharshar T, Bastuji-Garin S. Nurses' Working Conditions and the Nursing Shortage. JAMA. 2003;289(13):1633-1635. doi:10.1001/jama.289.13.1633-a