title: ICU-Acquired Weakness.
abstract: 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.
authors.affiliation: Section of Pulmonary/Critical Care Medicine and Allergy/Immunology, Louisiana State University Health Sciences Center, New Orleans, LA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Jolley
authors.affiliation: Department of Rehabilitation Medicine, Harborview Medical Center, University of Washington, Seattle, WA.
authors.forename: Aaron E
authors.initials: AE
authors.lastname: Bunnell
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, WA. Electronic address: cterrlee@uw.edu.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hough
mesh_terms: D000203:Activities of Daily Living; D016638:Critical Illness; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D009468:Neuromuscular Diseases / Q000209:etiology* / Q000503:physiopathology*; D011788:Quality of Life; D012307:Risk Factors
keywords: ICU neuromuscular dysfunction; ICU rehabilitation; ICU-acquired weakness; critical illness myopathy; critical illness polyneuropathy