Rethinking Muscle Wasting in Critical Illness: A Systematic Review and Meta-Analysis of Myofiber Size and Protein Turnover

The authors aimed to investigate the biological mechanisms underlying skeletal muscle dysfunction in critically ill adults by conducting a systematic review and meta-analysis of myofiber size and protein turnover. They found that myofiber cross-sectional area was significantly reduced in critically ill patients compared to controls, while protein synthesis rates did not differ significantly; however, markers of protein degradation were notably elevated. These findings suggest that muscle wasting in critical illness is driven by complex biological changes, including myofiber atrophy and increased protein degradation.