The intensive care medicine research agenda for the management of ICU acquired weakness: a multinational, interprofessional perspective.

DOI
Publisher DOI
PubMed ID
41182389
Abstract
Intensive care unit acquired weakness (ICUAW) is common in critically ill patients, contributing to substantial morbidity. Major trials and novel mechanistic findings published over the past years have advanced knowledge for the prevention and treatment of ICUAW. To streamline future research priorities, a multinational, interdisciplinary group of ICU clinicians, researchers, and people with lived experience convened to develop this evidence-based research agenda. Using a stepwise process including a systematic review with meta-analysis, two expert panel meetings, and a two-round modified Delphi method, we identified the top ten research priorities for ICUAW. Our report highlights the lack of reliable prognostic markers and mechanistic understanding that limit early diagnosis and treatment. Current evidence to treat ICUAW supports enhanced physical rehabilitation versus no rehabilitation, while higher dose enterally-delivered protein alone does not improve patient outcomes. However, the direct effects on muscles or appropriate dosing for patients with comorbidities remain largely unknown. The proposed ten key priority research questions integrate pathophysiology, diagnostics, treatment, and follow-up and emphasise personalised medicine and patient-centred outcomes over the continuum of recovery. Future research should focus on early prognostic markers, mechanisms of ICUAW, and identification of treatment responders allowing individualised dosing strategies tailored across the recovery trajectory. Defining meaningful outcomes, improving follow-up care, and integrating patient, family and caregiver priorities are essential. Advancing this agenda will require interdisciplinary collaboration and the use of emerging methods, including artificial intelligence, to support personalised and effective ICUAW care.
Date Issued
2025-12
Publication Type
Article
Subjects
Critical illness myopathy
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Diaphragm dysfunction
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Muscle weakness
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Physical function
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Polyneuropathy
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Rehabilitation
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Research priorities
Language(s)
en
Author(s)
Eggmann, Sabrina
Parry, Selina M
Broadley, Tessa
Lynch, Gordon S
Bongetti, Amy J
Ridley, Emma J
Ayre, Elizabeth
Bailey, Michael
Bellomo, Rinaldo
Berney, Sue
Bradley, Scott
Buhr, Heidi
Campbell, Marion K
Casey, Kelly
Chapple, Lee-Anne S
Connolly, Bronwen
Darvall, Jai
Deane, Adam
Febbraio, Mark A
Gosselink, Rik
Granger, Catherine L
Haines, Kimberley
Hanekom, Susan
Harhay, Michael O
Harrold, Meg
Hayes, Kate
Hermans, Greet
Higgins, Alisa
Jain, Snigdha
Kho, Michelle E
Kumar Tirupakuzhi Vijayaraghavan, Bharath
Lambell, Kate
Lang, Jenna K
Leditschke, Isabel Anne
Levinger, Itamar
Magana Cruz, Sherene
Marshall, Andrea P
Needham, Dale M
Ntoumenopoulos, George
Nydahl, Peter
Patel, Bhakti K
Paton, Michelle
Puthucheary, Zudin
Rooyackers, Olav
Schaller, Stefan J
Serpa Neto, Ary
Stoppe, Christian
Tronstad, Oystein
Vanhorebeek, Ilse
Hodgson, Carol L
Additional Credits
Journal
Intensive care medicine
ISSN
1432-1238
Access(Rights)
restricted
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