title: A case of intensive care unit-acquired weakness after emergency surgery for acute abdomen.
abstract: BACKGROUND
  Surgeons often perform surgery for patients who are critically ill. Intensive care unit (ICU)-acquired weakness (ICUAW) is a condition in which systemic and prolonged muscle weakness occurs and causes worse short-term and long-term outcomes.
  
  
  METHODS
  A 60-year-old woman with sudden nausea and vomiting presented to our hospital and developed shock. Abdominal CT showed thickness of the descending colon and ascites. She was diagnosed with sepsis due to descending colon cancer. Colectomy of the descending colon was performed due to necrosis, and a stoma was created. After surgery, she received intensive care in the ICU. It was difficult to wean her from the ventilator, and she developed severe flaccid weakness of the limbs. Her Medical Research Council (MRC) sum score was 0. Since other organic disorders causing prolonged paralysis were excluded, she was finally diagnosed as having ICUAW. Active rehabilitation, nutritional support, and glycemic control were continued. Now, 6 months after surgery, her MRC score has improved to 30.
  
  
  CONCLUSIONS
  The treatment for ICUAW has been reported to include recovery from the critical illness, early rehabilitation, and nutritional support, and it requires close cooperation among health care providers.
  
  
  CONCLUSIONS
  All physicians and surgeons who care for critically ill patients should take active steps to diagnose ICUAW in order to avoid deterioration of patients' activities of daily living.
authors.affiliation: Departments of Surgery, Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: tomitetsu2000@yahoo.co.jp.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Tominaga
authors.affiliation: Departments of Surgery, Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: tnonaka@nagasaki-mc.com.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.affiliation: Departments of Surgery, Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: takehiro@nagasaki-u.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.affiliation: Departments of Surgery, Rehabilitation, and Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: yhonda@nagasaki-u.ac.jp.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Honda
authors.affiliation: Departments of Surgery, Rehabilitation, and Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: hnagura@nagasaki-u.ac.jp.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nagura
authors.affiliation: Departments of Surgery, Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: tshiraishi@nagasaki-u.ac.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Shiraishi
authors.affiliation: Departments of Surgery, Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: kunisakimasaki2002@yahoo.co.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kunizaki
authors.affiliation: Departments of Surgery, Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: y-sumida@nagasaki-u.ac.jp.
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Sumida
authors.affiliation: Departments of Surgery, Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: hidaka-s@nagasaki-u.ac.jp.
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.affiliation: Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: sawai@nagasaki-u.ac.jp.
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.affiliation: Departments of Surgery, Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Japan. Electronic address: nagayasu@nagasaki-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
keywords: Critical illness; ICUAW; Rehabilitation; Surgeon