Skeletal muscle in critical illness

Skeletal muscle protein breakdown is a dominant feature of critical illness and is believed to be a useful biological response to injury. However the loss of muscle is accompanied by some major difficulties in medical management and complications for the patient. Protein turnover is difficult to study and the catabolic state is resistant to treatment, whether by nutritional or other strategies. This article provides an overview of the current physiological knowledge in this area, questions the usefulness of the catabolic response and highlights some new research worthy of further investigation.