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Open Access Minireview

ICU-acquired weakness: what is preventing its rehabilitation in critically ill patients?

Christie M Lee12 and Eddy Fan1*

Author Affiliations

1 Interdepartmental Division of Critical Care Medicine, University of Toronto, and the Division of Respirology, Department of Medicine, Mount Sinai Hospital and University Health Network, Toronto, Ontario, Canada

2 Mount Sinai Hospital, 600 University Avenue, Suite 18-201, Toronto, Ontario, Canada

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BMC Medicine 2012, 10:115  doi:10.1186/1741-7015-10-115

Published: 3 October 2012

Abstract

Intensive care unit-acquired weakness (ICUAW) has been recognized as an important and persistent complication in survivors of critical illness. The absence of a consistent nomenclature and diagnostic criteria for ICUAW has made research in this area challenging. Although many risk factors have been identified, the data supporting their direct association have been controversial. Presently, there is a growing body of literature supporting the utility and benefit of early mobility in reducing the morbidity from ICUAW, but few centers have adopted this into their ICU procedures. Ultimately, the implementation of such a strategy would require a shift in the knowledge and culture within the ICU, and may be facilitated by novel technology and patient care strategies. The purpose of this article is to briefly review the diagnosis, risk factors, and management of ICUAW, and to discuss some of the barriers and novel treatments to improve outcomes for our ICU survivors.

Keywords:
critical illness; early ambulation; extracorporeal membrane oxygenation; intensive care units; muscle weakness; physical therapy; rehabilitation