Weakness in the Intensive Care Unit: Current Therapies

David McWilliams, RD Griffiths

Research output: Contribution to journalArticlepeer-review


Intensive care unit (ICU)-acquired weakness (AW) is anincreasingly recognised disorder. It is associated withprolonged weaning from mechanical ventilation, longer ICUand hospital stays and increased mortality levels. ICU-AW iscaused by factors such as bed rest, prolonged immobility,sepsis, malnutrition, neuropathy and the use of corticosteroidsand neuromuscular-blocking agents. It has profoundphysiological, psychological and long-term consequences,including reduced muscle mass, cardiovasculardeconditioning, depression, muscle dysfunction and impairedfunctional status. Current therapies focus on preventivemeasures and early rehabilitation. A proactive approach to theremoval of sedation can facilitate earlier waking, thus allowingearlier and more active rehabilitation. Continuous passivemotion and electrical muscle stimulation may also play a role.In terms of early rehabilitation, patient mobilisation should bebased on an assessment of cardiovascular stability andrespiratory reserve. Early mobilisation has been demonstratedto reduce weaning times and decrease ICU length of stay, andultimately lead to shorter stays in hospital. Post ICUrehabilitation is also important and should not be neglected.The involvement of a multi-disciplinary team can ensure thebest outcomes for patients at risk of ICU-AW.
Original languageEnglish
Pages (from-to)23-27
Number of pages5
JournalBritish Journal of Intensive Care
Issue number2011
Publication statusPublished - Jun 2011
Externally publishedYes


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