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Semin Respir Crit Care Med 2013; 34(04): 522-528
DOI: 10.1055/s-0033-1351126
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Lung-Injured Patients Do Not Need a Specialized Rehabilitation Program: ICUAW as a Case Study

Margaret Herridge
1   Critical Care and Pulmonary Medicine, University Health Network/University of Toronto, Toronto, Ontario, Canada
,
Jane Batt
2   Pulmonary Medicine, St. Michael's Hospital/University of Toronto, Toronto, Ontario, Canada
,
Claudia C. Dos Santos
3   Critical Care Medicine, St. Michael's Hospital/University of Toronto, Toronto, Ontario, Canada
,
Jill I. Cameron
4   Department of Occupational Science and Occupational Therapy, Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario, Canada
› Author Affiliations
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Publication History

Publication Date:
11 August 2013 (online)

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Abstract

An episode of critical illness is transformative. Patients suffer important new nerve, brain, and muscle injury. The spectrum of morbidity varies according to individual risks, but prevalent disabilities transcend diagnostic groupings. In the context of intensive care unit–acquired weakness (ICUAW), each patient who enters the ICU will begin to degrade muscle through upregulation of different proteolytic pathways, and, although the inciting stimulus, or its magnitude, may differ somewhat across patients, the result is the same. This argues for an approach to rehabilitation that is etiologically neutral and based on an understanding of molecular pathophysiology that can be mapped to functional outcome and tailored to individual need.

Keywords

ICU-acquired weakness - rehabilitation - muscle biology - critical illness - outcomes
 

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