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. 2021 Sep;25(9):1006-1012.
doi: 10.5005/jp-journals-10071-23975.

Intensive Care Unit-acquired Neuromuscular Weakness: A Prospective Study on Incidence, Clinical Course, and Outcomes

Skaria Baby  1 , Christina George  2 , Narjeet M Osahan  3
Affiliations

Intensive Care Unit-acquired Neuromuscular Weakness: A Prospective Study on Incidence, Clinical Course, and Outcomes

Skaria Baby et al. Indian J Crit Care Med. 2021 Sep.

Abstract

Background: Neuromuscular weakness may manifest subsequent to critical illness in intensive care unit (ICU) patients. This weakness termed as "ICU-acquired weakness" (ICUAW) has a significant bearing on the length of mechanical ventilation, duration of ICU stays, long-term disability, and survival rate. Early identification of ICUAW helps in planning appropriate strategies, as well as in predicting the prognosis and long-term outcomes of these patients.

Aims and objectives: To identify the incidence of new-onset neuromuscular weakness developing among patients admitted in the ICU (ICUAW) and study its clinical course and impact on the duration of ICU stay.

Methods: This prospective observational study evaluated patients admitted to the ICU over a period of 1 year and 3 months (November 1, 2015, to January 31, 2017). All patients fulfilling the inclusion and exclusion criteria were evaluated with the Medical Research Council (MRC) score for muscle strength. Patients with an average score <4 were diagnosed with ICUAW. Included patients were examined on alternate days to study the clinical progression of the weakness till ICU discharge or death of the patient. The duration of ICU stay was noted.

Results and conclusion: The study revealed a significant association of ICUAW with age, Acute Physiology And Chronic Health Evaluation (APACHE II) Score, duration of mechanical ventilation, and ICU mortality. The incidence of the weakness was found to be 7.83% among the patients who survived and 50% among those patients who did not survive critical illness.

How to cite this article: Baby S, George C, Osahan NM. Intensive Care Unit-acquired Neuromuscular Weakness: A Prospective Study on Incidence, Clinical Course, and Outcomes. Indian J Crit Care Med 2021;25(9):1006-1012.

Keywords: Intensive care unit; Medical Research Council score; Neuromuscular weakness.

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Fig. 1
Fig. 1
Age distribution pattern of patients included in the study
Fig. 2
Fig. 2
Age-wise distribution of ICUAW
Fig. 3
Fig. 3
Correlation of APACHE II score with ICUAW
Fig. 4
Fig. 4
Mean MRC scores in patients with and without ICUAW (Red line—Patients with ICUAW; Blue line—Patients without ICUAW)
Fig. 5
Fig. 5
Comparison of the number of days of ICU stay in patients with and without ICUAW
Fig. 6
Fig. 6
Comparison of the number of days of mechanical ventilation in patients with and without ICUAW
Fig. 7
Fig. 7
Mortality and recovery among ICU patients with ICUAW
Fig. 8
Fig. 8
Percentage of patients with ICUAW
See this image and copyright information in PMC

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