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From skeletal muscle weakness to functional outcomes following critical illness: a translational biology perspective
  1. Jane Batt1,2,
  2. Margaret S Herridge2,3,
  3. Claudia C dos Santos1,2
  1. 1 Keenan Research Center for Biomedical Science, St Michael's Hospital, Toronto, Ontario, Canada
  2. 2 Interdepartmental Division of Critical Care Medicine and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  3. 3 Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
  1. Correspondence to Dr Jane Batt, Keenan Research Center for Biomedical Science, St Michael's Hospital, Toronto, ON M5B 1W8, Canada; jane.batt{at}


Intensive care unit acquired weakness (ICUAW) is now a well-known entity complicating critical illness. It increases mortality and in the critical illness survivor it is associated with physical disability, substantially increased health resource utilisation and healthcare costs. Skeletal muscle wasting is a key driver of ICUAW and physical functional outcomes in both the short and long term. To date, there is no intervention that can universally and consistently prevent muscle loss during critical illness, or enhance its recovery following intensive care unit discharge, to improve physical function. Clinical trials of early mobilisation or exercise training, or enhanced nutritional support have generated inconsistent results and we have no effective pharmacological interventions. This review will delineate our current understanding of the mechanisms underpinning the development and persistence of skeletal muscle loss and dysfunction in the critically ill individual, highlighting recent discoveries and clinical observations, and utilisation of this knowledge in the development of novel therapeutics.

  • critical care

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  • Contributors All authors contributed in the writing of the manuscript and/or have provided useful comments and additional text to improve the manuscript. Critical decisions regarding important intellectual content was undertaken by all authors.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.