Early detection and assessment of intensive care unit-acquired weakness: a comprehensive review

Abstract

Intensive care unit-acquired weakness (ICU-AW) is a serious complication in critically ill patients. Therefore, timely and accurate diagnosis and monitoring of ICU-AW are crucial for effectively preventing its associated morbidity and mortality. This article provides a comprehensive review of ICU-AW, focusing on the different methods used for its diagnosis and monitoring. Additionally, it highlights the role of bedside ultrasound in muscle assessment and early detection of ICU-AW. Furthermore, the article explores potential strategies for preventing ICU-AW. Healthcare providers who manage critically ill patients utilize diagnostic approaches such as physical exams, imaging, and assessment tools to identify ICU-AW. However, each method has its own limitations. The diagnosis of ICU-AW needs improvement due to the lack of a consensus on the appropriate approach for its detection. Nevertheless, bedside ultrasound has proven to be the most reliable and cost-effective tool for muscle assessment in the ICU. Combining the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score assessment, and ultrasound can be a convenient approach for the early detection of ICU-AW. This approach can facilitate timely intervention and prevent catastrophic consequences. However, further studies are needed to strengthen the evidence.

Construction and evaluation of acquired weakness nomogram model in patients with mechanical ventilation in intensive care unit

“… 23 Avoiding hyperglycemia and minimizing sedation are effective preventive measures for reducing the occurrence of ICU-acquired weakness. 24 Early prediction of the disease risk and development of preventive measures remain the best options for intervention. We emphasized that MV may be associated with a poor long-term prognosis in ICU patients, resulting in a range of severe organ damage.…”

Advancing critical care recovery: The pivotal role of machine learning in early detection of intensive care unit-acquired weakness

“…Despite these diagnostic tools, the practical challenges in critically ill patients, such as edema, sedation, and the physical limitations of the ICU environment, often complicate the assessment of muscle strength and function. Furthermore, Imaging techniques like muscle ultrasound and magnetic resonance imaging can supplement the diagnostic process by visualizing muscle atrophy and infiltration but are not routinely accessible in all settings[ 15 ]. The variability in patient cooperation, the invasiveness of certain procedures, and the need for specialized equipment or expertise underscore the diagnostic uncertainties and highlight the necessity for predictive tools that can efficiently identify ICU-AW early in its course.…”

“…The lack of a definitive treatment for ICU-AW underscores the necessity for a multifaceted approach, beginning with its early detection to mitigate the deleterious consequences. Thus, Early detection will enable healthcare providers to implement comprehensive strategies starting from early mobilization and electrical stimulation to meticulous glycemic control, judicious use of corticosteroids and neuromuscular blocking agents, tailored nutritional support, and the application of passive range-of-motion exercises to maintain joint flexibility and muscle length[ 15 , 17 , 24 ]. The integration of these strategies, tailored to individual patient needs, represents a proactive stance against the debilitating effects of ICU-AW.…”