Chronic critical illness
ARDS frequently necessitates invasive mechanical ventilation (risking
secondary infection), use of sedation, and potential for further injury
to the lungs. Sedation required for ventilation may worsen encephalopathy
and delirium, decrease mobility, potentiate catabolism and lead
to prolonged neuromuscular impairment during recovery.
Loss of the epithelial barrier in the gut, aside from causing bacteria
to enter the body, also impairs nutrition at a time where excess metabolic
demand and ongoing catabolism require increased nutrient intake.