Neuromuscular sequelae in survivors of acute lung injury

Pulmonary function improves rapidly in most survivors of ALI, yet most have profound and life-altering physical impairment. Critical illness polyneuropathy and myopathy (CIPM) are complications that may account for most long-term disability. Short-term morbidity includes difficulty weaning from mechanical ventilation, return to assisted breathing after weaning, and delayed return home after hospital discharge. Therapies that reduce sepsis and prolonged mechanical ventilation may minimize CIPM, as in intensive insulin treatment of ICU hyperglycemia. CIPM identification is important for ALI patients' care and prognostication. Observational studies are needed to understand the epidemiology and natural history of CIPM; interventional studies with CIPM and functional outcomes as major endpoints are essential for improvement of ALI patients' health and quality of life.