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Contemporary Reviews in Critical Care Medicine |

Intensive Care Unit Acquired Weakness

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

Conflict of interest statement: The authors have no conflicts of interest to report.

Funding information: Dr. Jolley is supported in part by 1 U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health 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.

Corresponding author: Catherine Hough, MD, MSc Harborview Medical Center 325 Ninth Avenue Seattle, WA 98104


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


Chest. 2016. doi:10.1016/j.chest.2016.03.045
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Abstract

Survivorship after critical illness is an increasingly important health care concern as intensive unit care (ICU) utilization continues to increase while ICU mortality is decreasing. Critical illness survivors experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay1-7. Newfound impairment is associated with increased healthcare costs and utilization, reductions in health related quality of life and prolonged unemployment5,8,9. Weakness, critical illness neuropathy and/or myopathy, and muscle atrophy are common in critically ill patients with up to 80% of patients admitted to the ICU developing some form of neuromuscular dysunction1,10,11. 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 around identifying high risk patients for its development and understanding its role in long-term outcomes after critical illness. This review addresses the epidemiology and pathophysiology of ICUAW, highlights the diagnostic challenges associated with its diagnosis in critically ill patients and proposes a novel strategy for identifying ICUAW.


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