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JCOM Abstract


J Clin Outcomes Manage 
2013 May;20(5):223-231
ICU-acquired weakness and early rehabilitation in the critically ill
Koo KKY, Fan E

ABSTRACT Objective: To provide an overview of intensive care unit–acquired weakness (ICUAW), summarize recent clinical trials on early rehabilitation in the ICU, and highlight novel strategies that may minimize the burden of this syndrome. Methods: Review of the literature. Results: Over the past decade, studies have revealed that a significant proportion of survivors of critical illness suffer from profound neuromuscular weakness and consequent impairment in functional status and quality of life. Immobility, deep sedation, and inflammation likely contribute to the development of ICUAW. Clinical trials suggest that early rehabilitation during acute critical illness may minimize ICUAW and improve patient-important outcomes. Therapeutic strategies must incorporate a paradigm shift where multi-disciplinary efforts at early mobilization are prioritized and supported. Novel technology and interventions, such as neuromuscular electrical stimulation and cycle ergometry, may facilitate early rehabilitation in critically ill patients. Conclusion: Future efforts are needed to identify barriers to the provision of early rehabilitation and to rigorously evaluate novel interventions

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