A 60-year-old man is in the ICU with respiratory failure secondary to severe influenza pneumonia. He

A 60-year-old man is in the ICU with respiratory failure
secondary to severe influenza pneumonia. He has developed acute respiratory
distress syndrome (ARDS), and gas exchange is severely impaired, with a
PaO2/FiO2 ratio of 90. He is requiring relatively high positive end expiratory
pressure (PEEP) and FiO2 to maintain adequate SaO2. He has been hypotensive
because of septic shock from his influenza and required pressors via a central
line immediately after admission to the unit and intubation for the initiation
of mechanical ventilation. He also has diabetes. Along with the immediate needs
for stabilization, resuscitation, and supportive care, the ICU team needs to
consider what impact their therapeutic choices now will have on his risk for
developing critical illness myopathy.

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