Combining nutrition and exercise to optimize survival and recovery from critical illness: Conceptual and methodological issues

Clin Nutr. 2016 Oct;35(5):1196-206. doi: 10.1016/j.clnu.2015.07.003. Epub 2015 Jul 16.


Survivors of critical illness commonly experience neuromuscular abnormalities, including muscle weakness known as ICU-acquired weakness (ICU-AW). ICU-AW is associated with delayed weaning from mechanical ventilation, extended ICU and hospital stays, more healthcare-related hospital costs, a higher risk of death, and impaired physical functioning and quality of life in the months after ICU admission. These observations speak to the importance of developing new strategies to aid in the physical recovery of acute respiratory failure patients. We posit that to maintain optimal muscle mass, strength and physical function, the combination of nutrition and exercise may have the greatest impact on physical recovery of survivors of critical illness. Randomized trials testing this and related hypotheses are needed. We discussed key methodological issues and proposed a common evaluation framework to stimulate work in this area and standardize our approach to outcome assessments across future studies.

Keywords: Clinical trials; Enteral nutrition; Exercise; Outcomes research; Parenteral nutrition; Rehabilitation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Critical Illness / rehabilitation*
  • Diet*
  • Exercise*
  • Humans
  • Intensive Care Units
  • Length of Stay
  • Muscle Weakness / rehabilitation
  • Neuromuscular Diseases / rehabilitation
  • Nutrition Assessment
  • Nutritional Status
  • Quality of Life
  • Respiration, Artificial