A systematic review and meta-analysis of risk factors for intensive care unit acquired weakness

Yang, Zi; Wang, Xiaohui; Wang, Faying; Peng, Zeyu; Fan, Yuying

doi:10.1097/md.0000000000031405

Cited by 16 publications

(7 citation statements)

References 49 publications

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“…Several risk factors are associated with CIW, with the main ones being prolonged inflammatory status [ 11 – 13 ], multiorgan failure, prolonged mechanical ventilation, and ICU length of stay [ 14 ]. As evidence, severity scores correlate highly with CIW [ 15 ].…”

Section: Critical Illness Weaknessmentioning

confidence: 99%

Critical illness-associated limb and diaphragmatic weakness

Le Stang,

Latronico,

Dres

et al. 2024

Current Opinion in Critical Care

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Purpose of review In the current review, we aim to highlight the evolving evidence on the diagnosis, prevention and treatment of critical illness weakness (CIW) and critical illness associated diaphragmatic weakness (CIDW). Recent findings In the ICU, several risk factors can lead to CIW and CIDW. Recent evidence suggests that they have different pathophysiological mechanisms and impact on outcomes, although they share common risk factors and may overlap in several patients. Their diagnosis is challenging, because CIW diagnosis is primarily clinical and, therefore, difficult to obtain in the ICU population, and CIDW diagnosis is complex and not easily performed at the bedside. All of these issues lead to underdiagnosis of CIW and CIDW, which significantly increases the risk of complications and the impact on both short and long term outcomes. Moreover, recent studies have explored promising diagnostic techniques that are may be easily implemented in daily clinical practice. In addition, this review summarizes the latest research aimed at improving how to prevent and treat CIW and CIDW. Summary This review aims to clarify some uncertain aspects and provide helpful information on developing monitoring techniques and therapeutic interventions for managing CIW and CIDW.

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Section: Critical Illness Weaknessmentioning

confidence: 99%

Critical illness-associated limb and diaphragmatic weakness

Le Stang,

Latronico,

Dres

et al. 2024

Current Opinion in Critical Care

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“…Another meta-analysis targeting five cohort studies also suggested a possible association between the use of NMBAs and ICU-AW (OR: 1.43, 95%CI: 0.92-2.22, I 2 = 0%). 85 Although these observational studies suggest a possible relationship between NMBAs and ICU-AW, the lack of intervention studies means that a clear causal relationship between NMBAs and ICU-AW is still unclear, and further research is needed.…”

Section: Neuromuscular Blocking Agentsmentioning

confidence: 99%

“…In this meta‐analysis, NMBAs were divided into benzyl quinolinic NMBAs (atracurium and cisatracurium) and amino‐steroid NMBAs (vecuronium and pancuronium) and their relationship with ICU‐AW was (OR: 14.79, 95% CI: 1.19–183.84, I 2 = 82%) and (OR: 3.68, 95% CI: 1.51–9.00, I 2 = 37%), respectively. Another meta‐analysis targeting five cohort studies also suggested a possible association between the use of NMBAs and ICU‐AW (OR: 1.43, 95%CI: 0.92–2.22, I 2 = 0%) 85 . Although these observational studies suggest a possible relationship between NMBAs and ICU‐AW, the lack of intervention studies means that a clear causal relationship between NMBAs and ICU‐AW is still unclear, and further research is needed.…”

Section: Drugs or Drug Prescriptions That May Lead To Sarcopenia Or M...mentioning

confidence: 99%

Drug‐related sarcopenia as a secondary sarcopenia

Kuzuya

2023

Geriatrics Gerontology Int

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Sarcopenia has a significant impact on falls, physical function, activities of daily living, and quality of life in older adults, and its prevention and treatment are becoming increasingly important as the global population ages. In addition to primary age‐related sarcopenia, activity‐related sarcopenia, disease‐related sarcopenia, and nutrition‐related sarcopenia have been proposed as secondary sarcopenia. Polypharmacy and potentially inappropriate medication based on multiple diseases cause health problems in older patients. In some cases, drugs used for therapeutic or preventive purposes act on skeletal muscle as adverse drug reactions and induce sarcopenia. Although sarcopenia caused by these adverse drug reactions may be more common in older patients, in particular those taking many medications, drug‐related sarcopenia has not yet received much attention. This review summarizes drugs that may induce sarcopenia and emphasizes the importance of drug‐related sarcopenia as a secondary sarcopenia. Geriatr Gerontol Int 2023; ••: ••–••.

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“…ICU-AW has been associated with increased mortality, reduced physical function and reduced health-related quality of life [6,19,20]. Risk factors for developing ICU-AW include female sex, mechanical ventilation days, age, infectious disease, increased organ failure score, hyperglycaemia and renal replacement therapy [21 ▪ ]. Assessing ICU-AW at the bedside continues to be a useful clinical tool to identify patients with increased care requirements in hospital and after hospital discharge [1,22].…”

Section: Icu-acquired Weakness and Patient-centred Outcomesmentioning

confidence: 99%

Physical rehabilitation, mobilization and patient-centred outcomes: what is new?

Broadley,

Higgins,

Hodgson

2023

Current Opinion in Critical Care

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Purpose of review Physical rehabilitation and mobilization interventions aim to reduce the incidence of intensive care unit (ICU)-acquired weakness and subsequently reduce morbidity in critically ill patients. This chapter will explore the evidence for physical rehabilitation and mobilization with an emphasis on patient-centred outcomes selected in randomized controlled trials. This is particularly pertinent at a time when clinicians are deciding how to implement physical rehabilitation and mobilization into the treatment of critically ill patients. Recent findings Multiple trials of physical rehabilitation and mobilization were published in 2022 and 2023 with conflicting results. Analysing the complexities of physical rehabilitation research provides an insight into these results and will aid in the interpretation of trials of physical rehabilitation and mobilization. Summary Patient-centred outcomes are often utilized in physical rehabilitation and mobilization research, but this does not automatically correspond to an increase in research quality. Improving consistency in trials of physical rehabilitation will aid in the interpretation and translation of physical rehabilitation research.

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A systematic review and meta-analysis of risk factors for intensive care unit acquired weakness

Cited by 16 publications

References 49 publications

Critical illness-associated limb and diaphragmatic weakness

Critical illness-associated limb and diaphragmatic weakness

Drug‐related sarcopenia as a secondary sarcopenia

Physical rehabilitation, mobilization and patient-centred outcomes: what is new?

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