Care and treatments related to intensive care unit–acquired muscle weakness: A cohort study

Raurell-Torredà, M.; Arias-Rivera, S.; Martí, Joan-Daniel; Frade-Mera, M.J.; Zaragoza-García, Ignacio; Velasco-Sanz, T.R.; José‐Arribas, Alicia San; Blázquez-Martínez, Eva

doi:10.1016/j.aucc.2020.12.005

Cited by 19 publications

(11 citation statements)

References 49 publications

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“…In the present study, the presence of ICUAW among the participants with SARS-CoV-2 did not generate a greater loss of muscle mass, compared to other factors, such as age and days spent on MV. Unlike our results, Raurell-Torredà et al (2021) observed that, in critically ill patients with kidney disease connected to a mechanical ventilator for ≥48 h, the presence of ICUAW, female sex, and functional status prior to the ICU are factors related to a greater loss of muscle mass (Raurell-Torredà et al, 2021). However, in both studies, people older than 60 years were more susceptible to muscle atrophy.…”

Section: Discussioncontrasting

confidence: 96%

Characterization of muscle mass, strength and mobility of critically ill patients with SARS-CoV-2 pneumonia: Distribution by sex, age, days on mechanical ventilation, and muscle weakness

et al. 2023

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Objective: Quantify and categorize by sex, age, and time spent on mechanical ventilation (MV), the decline in skeletal muscle mass, strength and mobility in critically ill patients infected with SARS-CoV-2 and requiring mechanical ventilation while at intensive care unit (ICU).Design: Prospective observational study including participants recruited between June 2020 and February 2021 at Hospital Clínico Herminda Martin (HCHM), Chillán, Chile. The thickness of the quadriceps muscle was evaluated by ultrasonography (US) at intensive care unit admission and awakening. Muscle strength and mobility were assessed, respectively, through the Medical Research Council Sum Score (MRC-SS) and the Functional Status Score for the Intensive Care Unit Scale (FSS-ICU) both at awakening and at ICU discharge. Results were categorized by sex (female or male), age (<60 years old or ≥60 years old) and time spent on MV (≤10 days or >10 days).Setting: Intensive care unit in a public hospital.Participants: 132 participants aged 18 years old or above (women n = 49, 60 ± 13 years; men n = 85, 59 ± 12 years) admitted to intensive care unit with a confirmed diagnosis of severe SARS-CoV-2 and requiring MV for more than 48 h were included in the study. Patients with previous physical and or cognitive disorders were excluded.Interventions: Not applicable.Results: Muscle thickness have significantly decreased during intensive care unit stay, vastus intermedius (−11%; p = 0.025), rectus femoris (−20%; p < 0.001) and total quadriceps (−16%; p < 0.001). Muscle strength and mobility were improved at intensive care unit discharge when compared with measurements at awakening in intensive care unit (time effect, p < 0.001). Patients ≥60 years old or on MV for >10 days presented greater muscle loss, alongside with lower muscle strength and mobility.Conclusion: Critically ill patients infected with SARS-CoV-2 and requiring MV presented decreased muscle mass, strength, and mobility during their intensive care unit stay. Factors associated with muscle mass, such as age >60 years and >10 days of MV, exacerbated the critical condition and impaired recovery.

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Section: Discussioncontrasting

confidence: 96%

Characterization of muscle mass, strength and mobility of critically ill patients with SARS-CoV-2 pneumonia: Distribution by sex, age, days on mechanical ventilation, and muscle weakness

et al. 2023

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“…The result is shown in Figure 3 . Ten literatures [ 6 , 13 , 14 , 16 , 17 , 19 , 21 – 24 ] explored this content and tested for heterogeneity, P = .03, I 2 = 53%, indicating heterogeneity. After sensitivity analysis, Anastasopoulos [ 17 ] was the main source of heterogeneity.…”

Section: Resultsmentioning

confidence: 99%

“…The result is shown in Figure 6 . Eight literatures [ 14 , 16 , 17 , 19 , 20 , 22 – 24 ] explored this content and tested for heterogeneity, P = .001, I 2 = 78%, indicating heterogeneity. Therefore, we conducted a sensitivity study, excluding trials with relatively small sample sizes (n < 50), with a substantial change in overall estimates, OR = 6.33, 95% CI:5.05 to 7.61; P < .00001.…”

Section: Resultsmentioning

confidence: 99%

“…After further reading the whole study, 18 studies were removed, 10 articles were non-cohort studies, 4 articles did not mention relevant outcome indicators, and 4 articles had incomplete data. Eventually, 12 prospective cohort studies [13][14][15][16][17][18][19][20][21] met the inclusion criteria. The flowchat is shown in Figure 1.…”

Section: Literature Selectionmentioning

confidence: 99%

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

Yang

Wang

et al. 2022

Medicine

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Background: The aim of this meta-analysis is to systematically evaluate and summarize the risk factors of intensive care unit acquired weakness (ICU-AW), to provide evidence-based evidence for the formulation of prevention strategies for ICU-AW.Methods: PubMed, EMBASE, Web of Science, CBM (China Biology Medicine, China), Chinese National Knowledge Infrastructure, Chinese WANFANG, and VIP will be searched to define relevant risk factors for ICU-AW. The databases search period is from January 1, 2005 to August 13, 2021. The Newcastle Ottawa Scale (NOS) is used to evaluate the quality of the included studies. RevMan 5.3 analysis software will be used for meta-analysis.Results: This systematic review and meta-analysis included a total of 12 cohort studies, including 9 international journals and 3 Chinese journals, with a total of 1950 patients, of which 856 had ICU-AW. The results showed that the significant risk factors for ICU-AW included female (odds ratio [OR] = 1.34, 95% confidence interval [CI]: 1.06-1.71; P = .02), mechanical ventilation days (

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“…There was a clinically significant difference; according to the study by Claire (2018), it ranges from 1.4 to 3 points on the Intensive Care Unit Mobility Scale (IMS), which is one of the main mobility assessment scales in the ICU. It has been used as a binary variable, defined as passive mobilization or active mobilization, not making it possible to analyze whether the level of care and the performance of activities in and out of bed influence the results in the ICU [ 9 , 10 , 11 ]. That said, the aim of the present study was to classify the level of mobility of the sample based on verticalization and active distancing from the bed through the IMS score and from this analyze the chances of discharge, death, and readmission of individuals admitted to the ICU.…”

Section: Introductionmentioning

confidence: 99%

Limited Mobility to the Bed Reduces the Chances of Discharge and Increases the Chances of Death in the ICU

Moraes

Farias

Rezende

et al. 2021

Clinics and Practice

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Background: Progressive mobility in the ICU has been recommended; however, the definitions of low, moderate, and high mobility in the ICU still diverge between studies. Therefore, our objective was to classify the mobility of the sample from verticalization and active withdrawal from the bed, and from that, to analyze the chances of discharge, death, and readmission to the ICU. Materials and methods: This is an observational and retrospective study that consults the medical records of individuals admitted to the ICU of the University Hospital of Sergipe (HU/SE) between August 2017 and August 2018. Mobility level was classified based on the Intensive Care Unit Mobility Scale (IMS). Results: A total of 121 individuals were included. The mean age was 61.45 ± 16.45, being 53.7% female. Of these, 28 (23.1%) had low mobility, 33 (27.3%) had moderate mobility, and 60 (49.6%) had high mobility. Individuals with low mobility were 45 times more likely to die (OR = 45.3; 95% CI = 3.23–636.3) and 88 times less likely to be discharged from the ICU (OR = 0.22; 95% CI = 0.002–0.30). Conclusion: Those who evolved with low mobility had a higher chance of death and a lower chance of discharge from the ICU. Moderate and high mobility were not associated with the investigated outcomes.

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Care and treatments related to intensive care unit–acquired muscle weakness: A cohort study

Cited by 19 publications

References 49 publications

Characterization of muscle mass, strength and mobility of critically ill patients with SARS-CoV-2 pneumonia: Distribution by sex, age, days on mechanical ventilation, and muscle weakness

Characterization of muscle mass, strength and mobility of critically ill patients with SARS-CoV-2 pneumonia: Distribution by sex, age, days on mechanical ventilation, and muscle weakness

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

Limited Mobility to the Bed Reduces the Chances of Discharge and Increases the Chances of Death in the ICU

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