Related Experiment Video
Updated: May 5, 2026
Visualizing Lung Cellular Adaptations during Combined Ozone and LPS Induced Murine Acute Lung Injury
Published on: March 21, 2021
Physical complications in acute lung injury survivors: a two-year longitudinal prospective study
Eddy Fan1, David W Dowdy, Elizabeth Colantuoni
11Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. 2Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD. 3Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. 4Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. 5Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 6Division of Pulmonary, Allergy, and Critical Care Medicine, Emory University School of Medicine, Atlanta, GA. 7Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, MD. 8Johns Hopkins University School of Nursing, Baltimore, MD. 9Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. 10Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. 11Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD.
Objective:
Survivors of severe critical illness frequently develop substantial and persistent physical complications, including muscle weakness, impaired physical function, and decreased health-related quality of life. Our objective was to determine the longitudinal epidemiology of muscle weakness, physical function, and health-related quality of life and their associations with critical illness and ICU exposures.
Design:
A multisite prospective study with longitudinal follow-up at 3, 6, 12, and 24 months after acute lung injury.
Setting:
Thirteen ICUs from four academic teaching hospitals.
Patients:
Two hundred twenty-two survivors of acute lung injury.
Interventions:
None.
Measurements And Main Results:
At each time point, patients underwent standardized clinical evaluations of extremity, hand grip, and respiratory muscle strength; anthropometrics (height, weight, mid-arm circumference, and triceps skin fold thickness); 6-minute walk distance, and the Medical Outcomes Short-Form 36 health-related quality of life survey. During their hospitalization, survivors also had detailed daily evaluation of critical illness and related treatment variables. Over one third of survivors had objective evidence of muscle weakness at hospital discharge, with most improving within 12 months. This weakness was associated with substantial impairments in physical function and health-related quality of life that persisted at 24 months. The duration of bed rest during critical illness was consistently associated with weakness throughout 24-month follow-up. The cumulative dose of systematic corticosteroids and use of neuromuscular blockers in the ICU were not associated with weakness.
Conclusions:
Muscle weakness is common after acute lung injury, usually recovering within 12 months. This weakness is associated with substantial impairments in physical function and health-related quality of life that continue beyond 24 months. These results provide valuable prognostic information regarding physical recovery after acute lung injury. Evidence-based methods to reduce the duration of bed rest during critical illness may be important for improving these long-term impairments.
Related Concept Videos
01:10Atelectasis II: Pathophysiology
01:25Chronic Obstructive Pulmonary Disease-III: Symptoms and Complications.
Symptoms of COPD can be classified as primary or systemic. Primary symptoms relate to reduced airflow, while systemic or extrapulmonary symptoms relate to COPD's broader impact on the body.
Primary Symptoms of COPD:
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:23Chronic Obstructive Pulmonary Disease II: Emphysema
01:29Pneumonia II: Pathophysiology
01:27Pneumothorax-II
Clinical Manifestations: