Muscle matters: Transforming the care of intensive care unit acquired sarcopenia and myosteatosis

Core Tip

Core Tip: The growing recognition of intensive care unit (ICU)-acquired sarcopenia and myosteatosis underscores their profound impact on both short-term and long-term patient outcomes. They result from a convergence of metabolic, inflammatory, endocrine, and neuromuscular disturbances. These conditions lead to prolonged ventilation, extended ICU stays, higher mortality, and increased healthcare costs. With advancements in diagnostic technologies, such as computed tomography imaging and ultrasound, the link between ICU-related factors (e.g., mechanical ventilation, sepsis, and systemic inflammation) and muscle loss has become clearer. Early identification and management of these conditions are crucial for improving recovery rates and reducing the risk of disability. Current best practices emphasize a “bundled” approach: Optimize protein and calorie delivery, avoid deep sedation, when possible, mobilize early and often, and address deliriogenic and inflammatory factors that impede participation in rehab. These interventions, when implemented together, act synergistically to preserve muscle.