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Curr Opin Crit Care · Aug 2022
ReviewPoor physical recovery after critical illness: incidence, features, risk factors, pathophysiology, and evidence-based therapies.
- Yente Florine Niké Boelens, Max Melchers, and van ZantenArthur Raymond HubertARHDepartment of Intensive Care Medicine, Gelderse Vallei Hospital, Ede, The Netherlands.Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, The Netherlands..
- Department of Intensive Care Medicine, Gelderse Vallei Hospital, Ede, The Netherlands.
- Curr Opin Crit Care. 2022 Aug 1; 28 (4): 409416409-416.
Purpose Of ReviewTo summarize the incidence, features, pathogenesis, risk factors, and evidence-based therapies of prolonged intensive care unit (ICU) acquired weakness (ICU-AW). We aim to provide an updated overview on aspects of poor physical recovery following critical illness.Recent FindingsNew physical problems after ICU survival, such as muscle weakness, weakened condition, and reduced exercise capacity, are the most frequently encountered limitations of patients with postintensive care syndrome. Disabilities may persist for months to years and frequently do not fully recover. Hormonal and mitochondrial disturbances, impaired muscle regeneration due to injured satellite cells and epigenetic differences may be involved in sustained ICU-AW. Although demographics and ICU treatment factors appear essential determinants for physical recovery, pre-ICU health status is also crucial. Currently, no effective treatments are available. Early mobilization in the ICU may improve physical outcomes at ICU-discharge, but there is no evidence for benefit on long-term physical recovery.SummaryImpaired physical recovery is observed frequently among ICU survivors. The pre-ICU health status, demographic, and ICU treatment factors appear to be important determinants for physical convalescence during the post-ICU phase. The pathophysiological mechanisms involved are poorly understood, thereby resulting in exiguous evidence-based treatment strategies to date.Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.
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