TY - CHAP M1 - Book, Section TI - ICU-Acquired Weakness A1 - Schweickert, William A1 - Kress, John P. A2 - Schmidt, Gregory A. A2 - Kress, John P. A2 - Douglas, Ivor S. PY - 2023 T2 - Hall, Schmidt and Wood’s Principles of Critical Care, 5th Edition AB - KEY POINTSICU-acquired weakness (ICUAW) designates clinically detected weakness in critically ill patients in whom there is no plausible etiology other than critical illness. Patients with a suggestive history who are able to participate in a comprehensive bedside neuromuscular examination can be given this diagnosis.Electrophysiology testing, direct muscle stimulation, and biopsy may be necessary to characterize neuromuscular injury in the patient who is unable to participate in a comprehensive neuromuscular examination, is failing to improve function despite weeks of therapy, or for the patient with asymmetric weakness.When conducted, advanced testing, particularly electrophysiology tests, can characterize the specific phenotype of ICUAW including critical illness polyneuropathy, critical illness myopathy, a combination of the two (polyneuromyopathy), or prolonged neuromuscular blockade.The exact epidemiology of ICUAW is unknown. Studies show that 46% of patients with sepsis, multiorgan failure, or prolonged mechanical ventilation are diagnosed with ICUAW. In patients undergoing mechanical ventilation for 7 days or more, 25% develop ICUAW.Factors associated with the diagnosis of ICUAW include the presence of multisystem organ dysfunction, sepsis, SIRS, and hyperglycemia and the duration of mechanical ventilation. The only known therapy to prevent ICUAW has been strict glycemic control with insulin; however, adverse events with this therapy have impacted widespread utilization. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/09/07 UR - accessmedicine.mhmedical.com/content.aspx?aid=1201807024 ER -