Mixed
Persistent muscle weakness and atrophy in ICU survivors (6 months post-discharge) are driven by impaired muscle regrowth and decreased satellite cell content, rather than ongoing proteolysis, inflammation, or mitochondrial dysfunction.
For ICU survivors, visual muscle size is not a reliable indicator of functional recovery. If muscle size returns but strength does not, the issue is likely impaired contractile quality or lack of satellite cells, not ongoing muscle breakdown. Rehabilitation should focus on functional capacity and potentially regenerative strategies rather than just hypertrophy or anti-catabolic measures.
Long term weakness in ICU survivors results from heterogeneous muscle pathophysiology with variable combinations of muscle atrophy and impaired contractile capacity. These findings are not explained by ongoing muscle proteolysis, inflammation or diminished mitochondrial content. Sustained muscle atrophy is associated with decreased satellite cell content and compromised muscle regrowth, suggesting impaired regenerative capacity.
Why this rating
Pilot study with small sample size (n=11 at 6 months) and lack of pre-admission baseline biopsies limits generalizability.
Source
Mechanisms of Chronic Muscle Wasting and Dysfunction after an Intensive Care Unit Stay. A Pilot Study
Claúdia C. dos Santos et al. · American Journal of Respiratory and Critical Care Medicine · 2016
DOI 10.1164/rccm.201512-2344oc
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