de Jonghe et al reported a number of risk factors associated with intensive care unit-acquired weakness (ICUAW). Identifying risk factors allows for interventions that may improve outcomes. The authors are from Intensive Care Unit in Poissy and University of Cersailles Saint-Quentin en Yvelines in Garches, France


ICUAW is often an indication of critical illness neuromyopathy.

Risk Factor

Preventive Measures

mechanical ventilation for more than 5 to 7 days

try to reduce days on mechanical ventilation if possible

number of days with multiple organ failures (MOF) or on vasoactive drugs

prevent or treat causes of MOF such as septic shock aggressively

muscle inactivity with deconditioning or duration unconscious

early mobilization when possible, else active physical therapy; attention to nutrition to avoid muscle catabolism; improved sedation strategy to hasten return to consciousness


monitor blood glucose and avoid both hyperglycemia and hypoglycemia

corticosteroid therapy

minimize the use of corticosteroids

neuromuscular blocking agents

minimize use of neuromuscular agents; monitor with train-of-four to detect excessive blockade; use agents whose metabolism is independent of liver or renal function


A patient with one or more risk factors should be monitored for weakness following recovery, and early interventions made to address deficits.


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