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Muscle atrophy in ARDS patients is caused by inflammation and disuse, with histological features including atrophy of type II muscle fibers, partial loss of myosin, and infiltration by immune cells (Puthucheary et al., 2013).This muscle wasting contributes to impaired physical function and reduced capacity for muscle recruitment, which may further compromise respiratory muscles and immunity (Puthucheary and Prescott, 2017)