ICU-acquired weakness is diagnosed in approximately 1 million mechanically ventilated
patients annually.
1
This weakness is secondary to multiple mechanisms including myopathy, neuropathy,
deconditioning and protein malnutrition. In addition, ICU-acquired weakness is associated
with decreased quality of life and increased mortality.
2
Physical rehabilitation and nutritional support have the potential to improve muscle
strength and help maintain functional status.Keywords
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References
- An official American Thoracic society clinical practice guideline: the diagnosis of intensive care unit-acquired weakness in adults.Am J Respir Crit Care Med. 2014; 190: 1437-1446
- ICU-acquired weakness and recovery from critical illness.N Engl J Med. 2014; 371: 287-288
- Combining exercise, protein supplementation and electric stimulation to mitigate muscle wasting and improve outcomes for survivors of critical illness-The ExPres study.Heart & Lung. 2022;
- A multimodal rehabilitation program for patients with ICU acquired weakness improves ventilator weaning and discharge home.J Crit Care. 2018; 47: 204-210
- Effects of neuromuscular electrical stimulation in critically ill patients: a systematic review and meta-analysis of randomised controlled trials.Aust Crit Care. 2020; 33: 203-210
- Early active mobilization during mechanical ventilation in the ICU.N Engl J Med. 2022; 387: 1747-1758
Article info
Publication history
Published online: January 24, 2023
Accepted:
December 22,
2022
Received:
December 21,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Published by Elsevier Inc.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Combining exercise, protein supplementation and electric stimulation to mitigate muscle wasting and improve outcomes for survivors of critical illness—The ExPrES studyHeart & Lung: The Journal of Cardiopulmonary and Acute Care
- PreviewOlder patients who suffer from critical illness, particularly those requiring mechanical ventilation (MV), are at high risk for skeletal muscle wasting and loss of physical function from prolonged bed rest. This debilitated state can further perpetuate a prolonged Intensive Care Unit (ICU) stay resulting in increased mortality. The mechanisms for this muscle wasting are multifactorial and include endotoxin-mediated inflammation, nutritional inadequacy and altered substrate metabolism.1-5 Efforts at rehabilitating older, critically ill patients during an ICU admission vary from passive mobility and range of motion exercises in bed-bound patients6-8 to progressive ambulation.
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