Muscle in defense.

The physical inactivity of the critically ill patient is an abnormal state that compromises muscle function to an extent that the immobile skeletal muscle may not simply be a bystander in the disease process.Skeletal muscle seems to maintain a system of defense against inflammation through heat shock proteins and the production of myokines. It contributes in a bidirectional role in systemic inflammatory signaling and the modulation of the inflammatory response. Skeletal muscle is a major contributor to whole-body glucose and protein metabolism, exemplified by its role in nutrient provision for the immune system and other rapidly dividing tissues through glutamine production.