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Review Article
Surgery
Early detection and assessment of intensive care unit-acquired weakness: a comprehensive review
Hanan Elkalawy, Pavan Sekhar, Wael Abosena
Acute Crit Care. 2023;38(4):409-424.   Published online November 30, 2023
DOI: https://doi.org/10.4266/acc.2023.00703
  • 2,550 View
  • 252 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDF
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.

Citations

Citations to this article as recorded by  
  • Characteristics of the Cerebrospinal Fluid in Septic Patients with Critical Illness Polyneuropathy - A Retrospective Cohort Study
    Yanyang Zhang, Jinfu Ma, Qing Zhao, Hui Liu
    The Journal of Critical Care Medicine.2024; 10(2): 130.     CrossRef
  • Advancing critical care recovery: The pivotal role of machine learning in early detection of intensive care unit-acquired weakness
    Georges Khattar, Elie Bou Sanayeh
    World Journal of Clinical Cases.2024; 12(21): 4455.     CrossRef
Original Article
Neurology
The Effect of Electrical Muscle Stimulation and In-bed Cycling on Muscle Strength and Mass of Mechanically Ventilated Patients: A Pilot Study
Kyeongyoon Woo, Jeongmin Kim, Hye Bin Kim, Hyunwoo, Choi, Kibum Kim, Donghyung Lee, Sungwon Na
Acute Crit Care. 2018;33(1):16-22.   Published online February 14, 2017
DOI: https://doi.org/10.4266/acc.2017.00542
  • 9,516 View
  • 341 Download
  • 11 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Background
Critically ill patients experience muscle weakness, which leads to functional disability. Both functional electrical stimulation (FES) and in-bed cycling can be an alternative measure for intensive care unit (ICU) patients who are not feasible for active exercise. The aim of this study was to examine whether FES and in-bed cycling have a positive effect on muscle mass in ICU patients.
Methods
Critically ill patients who received mechanical ventilation for at least 24 hours were included. After passive range of motion exercise, in-bed cycling was applied for 20 minutes, and FES was applied for 20 minutes on the left leg. The right leg received in-bed cycling and the left leg received both FES and in-bed cycling. Thigh circumferences and rectus femoris cross-sectional area (CSA) were assessed with ultrasonography before and after the intervention. Muscle strength was assessed by Medical Research Council scale.
Results
A total of 10 patients were enrolled in this study as a pilot study. Before and after the intervention, the CSA of right rectus femoris increased from 5.08 ± 1.51 cm2 to 6.01 ± 2.21 cm2 , which was statistically significant (P = 0.003). The thigh circumference was also increased and statistically significant (P = 0.006). There was no difference between left and right in regard to FES application. There is no significant change in muscle strength before and after the intervention (right and left, P = 0.317 and P = 0.368, respectively).
Conclusions
In-bed cycling increased thigh circumferences rectus femoris CSA. Adding FES did not show differences.

Citations

Citations to this article as recorded by  
  • Assisted mobilisation in critical patients with COVID-19
    M. Polastri, F. Daniele, F. Tagariello
    Pulmonology.2024; 30(2): 152.     CrossRef
  • Ultrasound for measurement of skeletal muscle mass quantity and muscle composition/architecture in critically ill patients: A scoping review on studies' aims, methods, and findings
    Júlia Lima, Estéfani Foletto, Rafaella C.B. Cardoso, Charlles Garbelotto, Aline P. Frenzel, Juliana U. Carneiro, Larissa S. Carpes, Thiago G. Barbosa-Silva, Maria Cristina Gonzalez, Flávia M. Silva
    Clinical Nutrition.2024; 43(1): 95.     CrossRef
  • Current Concepts in Early Mobilization of Critically Ill Patients Within the Context of Neurologic Pathology
    Thaís Ferreira Lopes Diniz Maia, Paulo André Freire Magalhães, Dasdores Tatiana Silva Santos, Jorge Luiz de Brito Gomes, Paulo Adriano Schwingel, Aline de Freitas Brito
    Neurocritical Care.2024;[Epub]     CrossRef
  • Anabolic Strategies for ICU-Acquired Weakness. What Can We Learn from Bodybuilders?
    Jakub Tarnawski, Maja Czub, Marta Dymecki, Medha Sunil, Marcin Folwarski
    Nutrients.2024; 16(13): 2011.     CrossRef
  • Human skeletal muscle size with ultrasound imaging: a comprehensive review
    Masatoshi Naruse, Scott Trappe, Todd A. Trappe
    Journal of Applied Physiology.2022; 132(5): 1267.     CrossRef
  • Rehabilitation Therapy after the COVID-19 Era: Focused on Cardiopulmonary Rehabilitation
    Hyung Ik Shin
    Annals of CardioPulmonary Rehabilitation.2021; 1(1): 17.     CrossRef
  • Rehabilitation Programs for Bedridden Patients with Prolonged Immobility: A Scoping Review Protocol
    Vitor Parola, Hugo Neves, Filipa Margarida Duque, Rafael A. Bernardes, Remy Cardoso, Carla A. Mendes, Liliana B. Sousa, Paulo Santos-Costa, Cândida Malça, Rúben Durães, Pedro Parreira, João Apóstolo, Arménio Cruz
    International Journal of Environmental Research and Public Health.2021; 18(22): 12033.     CrossRef
  • Non-paretic lower limb muscle wasting during acute phase is associated with dependent ambulation in patients with stroke
    Masafumi Nozoe, Masashi Kanai, Hiroki Kubo, Miho Yamamoto, Shinichi Shimada, Kyoshi Mase
    Journal of Clinical Neuroscience.2020; 74: 141.     CrossRef
  • Intensive Care Unit-Acquired Weakness: Not Just Another Muscle Atrophying Condition
    Heta Lad, Tyler M. Saumur, Margaret S. Herridge, Claudia C. dos Santos, Sunita Mathur, Jane Batt, Penney M. Gilbert
    International Journal of Molecular Sciences.2020; 21(21): 7840.     CrossRef
  • Problems with Rehabilitation for Critically ill Patients
    Masaji Nishimura
    The Japanese Journal of Rehabilitation Medicine.2019; 56(1): 48.     CrossRef
  • Exploring the Potential Effectiveness of Combining Optimal Nutrition With Electrical Stimulation to Maintain Muscle Health in Critical Illness: A Narrative Review
    Selina M. Parry, Lee‐anne S. Chapple, Marina Mourtzakis
    Nutrition in Clinical Practice.2018; 33(6): 772.     CrossRef

ACC : Acute and Critical Care