Intensive Care Unit-Acquired Weakness: A Review of Recent Progress With a Look Toward the Future

Wang, Wenkang; Xu, Chen; Xing-long, MA; Zhang, Xiaoming; Xie, Peng

doi:10.3389/fmed.2020.559789

Cited by 65 publications

(64 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Intensive care unit-acquired weakness (ICU-AW) is a severe neuromuscular complication in critically ill patients, with a global incidence of 25–31% among the critically ill [ 1 ]. ICU-AW can affect the respiratory and limb muscles, leading to prolonged mechanical ventilation (MV), extended intensive care unit (ICU) stay, higher hospital costs, increased mortality, and decreased quality of life [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of early mobilization combined with early nutrition on acquired weakness in critically ill patients (EMAS): A dual-center, randomized controlled trial

Zhou

Fan

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

Aim The study aimed to investigate the effect of early mobilization combined with early nutrition (EMN) on intensive care unit-acquired weakness (ICU-AW) in intensive care unit (ICU) settings compared with early mobilization (EM) or routine care. Methods A prospective, dual-center, randomized controlled trial was conducted. The control group underwent standard care without a pre-established routine for mobilization and nutrition. The EM group underwent early, individualized, progressive mobilization within 24 h of ICU admission. The EMN group underwent early mobilization, similar to the EM group plus guideline-based early nutrition (within 48 h of ICU admission). The primary outcome was the occurrence of ICU-AW at discharge from the ICU. Secondary outcomes included muscle strength, functional independence, organ failure, nutritional status, duration of mechanical ventilation (MV), length of ICU stay, and ICU mortality at ICU discharge. Results A total of 150 patients were enrolled and equally distributed into the three groups. Patients undergoing routine care only were more susceptible to ICU-AW upon ICU discharge than those in the EM or EMN groups (16% vs. 2%; p = 0.014 for both), and had a lower Barthel Index than others (control vs. EM/EMN: 57.5 vs 70.0; p = 0.022). The EMN group had improved muscle strength (p = 0.028) and better nutritional status than the control group (p = 0.031). Both interventions were associated with a lower ICU-AW (EM vs. control: p = 0.027, OR [95% CI] = 0.066 [0.006–0.739]; EMN vs. control: p = 0.016, OR [95% CI] = 0.065 [0.007–0.607]). Conclusion EM and EMN had positive effects. There was little difference between the effects of EM and EMN, except for muscle strength improvement. Both EM and EMN may lead to a lower occurrence of ICU-AW and better functional independence than standard care. EMN might benefit nutritional status more than usual care and promote improvement in muscle strength.

show abstract

Section: Introductionmentioning

confidence: 99%

Effect of early mobilization combined with early nutrition on acquired weakness in critically ill patients (EMAS): A dual-center, randomized controlled trial

Zhou

Fan

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

show abstract

“… 2 Muscle weakness due to long-term use of corticosteroids occurred due steroids catabolic effect on skeletal muscles, that caused type II muscle fiber atrophy and proximal muscle weakness. 5 The effect of corticosteroid therapy on ICUAW is complex and may also depend on the duration and cumulative dosage of the corticosteroids. 6 ICUAW caused by excessive steroid use is difficult to diagnose due to insignificant changes in muscle enzymes and lack of specificity and diversity in the electrophysiological results.…”

Section: Discussionmentioning

confidence: 99%

“… 6 Nevertheless, disease related to long-term use of corticosteroids can only be determined with clinical symptoms. 5 In this case we considered steroid usage as a risk factor which contribute to develop ICUAW.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intensive Care Unit Acquired Weakness Associated With Acute Severe Asthma

Borré-Naranjo

Yánez

Almanza‐Hurtado

et al. 2022

Clin Med Insights Case Rep

View full text Add to dashboard Cite

Context: Neuromuscular complications in the intensive care unit (ICU) are frequent, multifactorial, and clinically difficult to recognize during their acute phase. The physical examination is the starting point for identification. Case Report: We present a patient with a history of poorly controlled asthma who was admitted to the ICU with status asthmaticus. After 4 days of being under ventilatory support, he developed muscle weakness. The diagnostic approach made it possible to establish myopathic and neurological compromise through electrophysiology studies. Conclusions: ICU-acquired weakness (ICUAW) can bring long-term consequences, early identification, and management, as well as preventive measures, are essential to minimize chronic disability and morbidity.

show abstract

“…Muscle atrophy occurs due to an imbalance between synthesis and uncontrolled degradation of muscle proteins. In critically ill patients, muscle atrophy is mainly a result of a massive loss of myosin and myoglobin-related proteins in limb and trunk muscles [ 7 ]. Long-term treatment of critically ill patients in the intensive care unit reduces hydrostatic pressure in the cardiovascular system, depletes skeletal muscle forces and reduces total energy expenditure, which has negative effects on the musculoskeletal system, cardiovascular system, and circulation and causes muscle weakness [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled clinical trial of the effects of range of motion exercises and massage on muscle strength in critically ill patients

Rahiminezhad

Sadeghi

Ahmadinejad

et al. 2022

BMC Sports Sci Med Rehabil

View full text Add to dashboard Cite

Background Atrophy and muscle weakness is a common problem in critically ill patients admitted to the intensive care unit (ICU). Muscle weakness in severe cases can lead to tetraplegia, reduced or lost tendon reflexes, delayed weaning from mechanical ventilation, physical disability, and increased mortality. The aim of this study was to compare the effects of range of motion exercises (ROM) and massage on muscle strength of the patients admitted to ICUs. Methods This study was a single-blinded randomized controlled trial conducted in ICUs of Afzalipour hospital in Kerman, southeastern Iran. Ninety conscious ICU patients were randomly divided into three groups (massage, ROM exercises and control). The researcher/co-researcher massaged or did ROM exercises on the patients’ extremities once a day for seven consecutive days. Using a hand-held dynamometer, the co-researcher, rated the muscle strength before, on the fourth and seventh days of intervention at 8 p.m. Results The mean muscles strength of the right arm in the ROM exercise and massage groups increased by 0.63 kg, and 0.29 kg, respectively after the intervention compared with before the intervention. The muscle strength of the right arm in the control group reduced by 0.55 kg. The mean muscles strength of the left arm in the ROM exercise and massage groups increased by 0.61 kg and 0.28 kg after the intervention, respectively while it reduced by 0.56 kg in the control group. The mean muscles strength of the right leg in the ROM exercise and massage groups increased by 0.53 kg and 0.27 kg after the intervention compared with before the intervention while it reduced by 0.70 kg in the control group. The mean muscles strength of the left leg in the ROM exercise and massage groups increased by 0.54 kg and 0.26 kg after the intervention compared with before the intervention while it reduced by 0.71 kg in the control group. Conclusion The results of the present study showed that ROM exercises and massage were effective interventions in increasing muscle strength of the critically ill patients admitted to intensive care units.

show abstract

Intensive Care Unit-Acquired Weakness: A Review of Recent Progress With a Look Toward the Future

Cited by 65 publications

References 81 publications

Effect of early mobilization combined with early nutrition on acquired weakness in critically ill patients (EMAS): A dual-center, randomized controlled trial

Effect of early mobilization combined with early nutrition on acquired weakness in critically ill patients (EMAS): A dual-center, randomized controlled trial

Intensive Care Unit Acquired Weakness Associated With Acute Severe Asthma

A randomized controlled clinical trial of the effects of range of motion exercises and massage on muscle strength in critically ill patients

Contact Info

Product

Resources

About