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

Daren K. Heyland, Renee D. Stapleton, Marina Mourtzakis, Catherine L. Hough, Peter Morris, Nicolaas E. Deutz, Elizabeth Colantuoni, Andrew Day, Carla M. Prado, Dale M. Needham

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


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.

Original languageEnglish
Pages (from-to)1196-1206
Number of pages11
JournalClinical Nutrition
Issue number5
StatePublished - Oct 1 2016

Bibliographical note

Funding Information:
DMN received support from the National Institutes of Health (grant number R24 HL111895 ). RDS receives support from National Institutes of Health grant K23HL105654 .

Publisher Copyright:
© 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism


  • Clinical trials
  • Enteral nutrition
  • Exercise
  • Outcomes research
  • Parenteral nutrition
  • Rehabilitation

ASJC Scopus subject areas

  • Nutrition and Dietetics
  • Critical Care and Intensive Care Medicine


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