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Contemporary Reviews in Critical Care Medicine |

ICU-Acquired Weakness

Sarah E. Jolley, MD; Aaron E. Bunnell, MD; Catherine L. Hough, MD
Author and Funding Information

FUNDING/SUPPORT: S. E. J. is supported in part by the National Institute of General Medical Sciences of the National Institutes of Health [Grant 1 U54 GM104940], which funds the Louisiana Clinical and Translational Science Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

aSection of Pulmonary/Critical Care Medicine and Allergy/Immunology, Louisiana State University Health Sciences Center, New Orleans, LA

bDepartment of Rehabilitation Medicine, Harborview Medical Center, University of Washington, Seattle, WA

cDivision of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, WA

CORRESPONDENCE TO: Catherine L. Hough, MD, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(5):1129-1140. doi:10.1016/j.chest.2016.03.045
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Survivorship after critical illness is an increasingly important health-care concern as ICU use continues to increase while ICU mortality is decreasing. Survivors of critical illness experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay. Newfound impairment is associated with increased health-care costs and use, reductions in health-related quality of life, and prolonged unemployment. Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in patients who are critically ill, with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysfunction. ICU-acquired weakness (ICUAW) is associated with longer durations of mechanical ventilation and hospitalization, along with greater functional impairment for survivors. Although there is increasing recognition of ICUAW as a clinical entity, significant knowledge gaps exist concerning identifying patients at high risk for its development and understanding its role in long-term outcomes after critical illness. This review addresses the epidemiologic and pathophysiologic aspects of ICUAW; highlights the diagnostic challenges associated with its diagnosis in patients who are critically ill; and proposes, to our knowledge, a novel strategy for identifying ICUAW.

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