TY - BOOK AU - Zorowitz, Richard D TI - ICU-Acquired Weakness: A Rehabilitation Perspective of Diagnosis, Treatment, and Functional Management. [Review] SN - 0012-3692 PY - 2016/// KW - *Critical Illness/rh [Rehabilitation] KW - *Intensive Care Units KW - *Muscle Weakness/rh [Rehabilitation] KW - *Muscular Diseases/rh [Rehabilitation] KW - *Polyneuropathies/rh [Rehabilitation] KW - Activities of Daily Living KW - Electromyography KW - Glucocorticoids/tu [Therapeutic Use] KW - Humans KW - Hyperglycemia/dt [Drug Therapy] KW - Hyperglycemia/ep [Epidemiology] KW - Hypoglycemic Agents/tu [Therapeutic Use] KW - Immobilization/sn [Statistics & Numerical Data] KW - Inflammation/ep [Epidemiology] KW - Insulin/tu [Therapeutic Use] KW - Long-Term Care KW - Multiple Organ Failure/ep [Epidemiology] KW - Muscle Weakness/di [Diagnosis] KW - Muscle Weakness/ep [Epidemiology] KW - Muscular Diseases/di [Diagnosis] KW - Muscular Diseases/ep [Epidemiology] KW - Neural Conduction KW - Neurologic Examination KW - Neuromuscular Blocking Agents/tu [Therapeutic Use] KW - Polyneuropathies/di [Diagnosis] KW - Polyneuropathies/ep [Epidemiology] KW - Rehabilitation Centers KW - Risk Factors KW - Sepsis/ep [Epidemiology] KW - MedStar National Rehabilitation Network KW - Journal Article KW - Review N1 - Available online from MWHC library: 1935 - present, Available in print through MWHC library: 1999 - 2006 N2 - Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved; ICU-acquired weakness (ICUAW) occurs with reported incidence rates from 25% to 100%. Risk factors include immobility, sepsis, persistent systemic inflammation, multiorgan system failure, hyperglycemia, glucocorticoids, and neuromuscular blocking agents. The pathophysiology remains unknown. Clinical features may be neuropathic, myopathic, or a combination of both. Although manual muscle testing is more practical in diagnosing ICUAW, the "gold standard" for the diagnosis of ICUAW remains electromyography and nerve conduction studies. The only potential interventions known to date to prevent ICUAW include insulin therapy and early rehabilitation, but patients still may develop activity limitations in the acute care hospital. For these patients, rehabilitation may continue in long-term care hospitals, inpatient rehabilitation facilities, or skilled nursing facilities. ICUAW is a catastrophic and debilitating condition that potentially leaves patients with permanent residual activity limitations and participation restrictions. Further research on ICUAW needs to better understand its pathophysiology so that more definitive preventive and therapeutic interventions may be developed UR - https://dx.doi.org/10.1016/j.chest.2016.06.006 ER -