Among these critically ill patients, muscle wasting occurred early and rapidly during the first week of critical illness and was more severe among those with multiorgan failure compared with single organ failure. These findings may provide insights into skeletal muscle wasting in critical illness. Survivors of critical illness experience significant skeletal muscle weakness and physical disability, which can persist for at least 5 years. Muscle wasting contributes substantially to weakness acquired in the intensive care unit (ICU), but its time course and underlying pathophysiological mechanisms remain poorly characterized and understood. In health, muscle mass is maintained through balanced protein breakdown and synthesis. For wasting to occur, breakdown must be increased relative to synthesis.

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