Risk Factors and Electromyographic Characteristics of Acquired Weakness in Critically Ill Patients: A Retrospective Study

IF 2.8 3区医学 Q1 Pharmacology, Toxicology and Pharmaceutics

Therapeutics and Clinical Risk Management Pub Date : 2024-08-01 DOI:10.2147/tcrm.s464722

Kun Li, Ahmad Alhaskawi, Haiyin Zhou, Yanzhao Dong, QingFang Zhao, Chenxi Wang, Hui Lu

{"title":"Risk Factors and Electromyographic Characteristics of Acquired Weakness in Critically Ill Patients: A Retrospective Study","authors":"Kun Li, Ahmad Alhaskawi, Haiyin Zhou, Yanzhao Dong, QingFang Zhao, Chenxi Wang, Hui Lu","doi":"10.2147/tcrm.s464722","DOIUrl":null,"url":null,"abstract":"Objective: This retrospective study examines risk factors and electromyographic (EMG) characteristics associated with acquired weakness in critically ill patients and assesses their impact on patient prognosis. Methods: Ninety-seven critically ill patients, ventilated for over 48 hours, were included. Patient data, encompassing general condition, medical history, Medical Research Council (MRC) scores, serum markers (c-reactive protein, calcitonin gene, albumin, brain natriuretic peptide, urea nitrogen, creatinine), EMG characteristics, respiratory treatment modalities, and parameters, were recorded. Mechanical ventilation duration, ICU stay duration, hospitalization duration, and patient prognosis were documented. Based on MRC scores, patients were categorized into the ICU-acquired weakness (ICU-AW) group (MRC < 48 points) and the non-ICU-AW group (MRC ≥ 48 points). Results: The study comprised 47 ICU-AW and 50 non-ICU-AW patients. Significant differences (p < 0.05) were observed in age, MRC scores, albumin levels, c-reactive protein, calcitonin gene, brain natriuretic peptide, urea nitrogen, creatinine, mechanical ventilation duration, ICU stay duration, and hospitalization duration between groups. In the ICU-AW group, nerve conduction examinations revealed slow conduction velocity, reduced wave amplitude, and in severe cases, a complete loss of motor and sensory potentials. Multivariate logistic analysis identified low serum albumin levels and MRC scores as potential ICU-AW risk factors. Conclusion: This study suggests that low serum albumin levels and MRC scores may contribute to ICU-AW risk. The ICU-AW group exhibited varied peripheral nerve damage and slow conduction velocities on EMG. Additionally, severe systemic inflammatory responses, renal function, brain natriuretic peptide levels, prolonged mechanical ventilation, and peripheral nerve damage may be associated with ICU-AW. Follow-up studies are essential for further understanding these complex interactions. Keywords: ICU-acquired weakness, risk factor, critical care, therapy, respiratory failure, electromyography ","PeriodicalId":22977,"journal":{"name":"Therapeutics and Clinical Risk Management","volume":null,"pages":null},"PeriodicalIF":2.8000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutics and Clinical Risk Management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/tcrm.s464722","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Pharmacology, Toxicology and Pharmaceutics","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: This retrospective study examines risk factors and electromyographic (EMG) characteristics associated with acquired weakness in critically ill patients and assesses their impact on patient prognosis.
Methods: Ninety-seven critically ill patients, ventilated for over 48 hours, were included. Patient data, encompassing general condition, medical history, Medical Research Council (MRC) scores, serum markers (c-reactive protein, calcitonin gene, albumin, brain natriuretic peptide, urea nitrogen, creatinine), EMG characteristics, respiratory treatment modalities, and parameters, were recorded. Mechanical ventilation duration, ICU stay duration, hospitalization duration, and patient prognosis were documented. Based on MRC scores, patients were categorized into the ICU-acquired weakness (ICU-AW) group (MRC < 48 points) and the non-ICU-AW group (MRC ≥ 48 points).
Results: The study comprised 47 ICU-AW and 50 non-ICU-AW patients. Significant differences (p < 0.05) were observed in age, MRC scores, albumin levels, c-reactive protein, calcitonin gene, brain natriuretic peptide, urea nitrogen, creatinine, mechanical ventilation duration, ICU stay duration, and hospitalization duration between groups. In the ICU-AW group, nerve conduction examinations revealed slow conduction velocity, reduced wave amplitude, and in severe cases, a complete loss of motor and sensory potentials. Multivariate logistic analysis identified low serum albumin levels and MRC scores as potential ICU-AW risk factors.
Conclusion: This study suggests that low serum albumin levels and MRC scores may contribute to ICU-AW risk. The ICU-AW group exhibited varied peripheral nerve damage and slow conduction velocities on EMG. Additionally, severe systemic inflammatory responses, renal function, brain natriuretic peptide levels, prolonged mechanical ventilation, and peripheral nerve damage may be associated with ICU-AW. Follow-up studies are essential for further understanding these complex interactions.

Keywords: ICU-acquired weakness, risk factor, critical care, therapy, respiratory failure, electromyography

查看原文本刊更多论文

重症患者后天乏力的风险因素和肌电图特征：回顾性研究

目的：本回顾性研究探讨了与危重病人获得性乏力相关的风险因素和肌电图（EMG）特征，并评估了这些因素对病人预后的影响：这项回顾性研究探讨了与危重病人获得性乏力相关的风险因素和肌电图（EMG）特征，并评估了它们对患者预后的影响：研究纳入了 97 名重症患者，这些患者通气时间超过 48 小时。患者数据包括一般状况、病史、医学研究委员会（MRC）评分、血清指标（c 反应蛋白、降钙素基因、白蛋白、脑钠肽、尿素氮、肌酐）、肌电图特征、呼吸治疗方式和参数。记录了机械通气时间、重症监护室住院时间、住院时间和患者预后。根据 MRC 评分，将患者分为 ICU 获得性乏力（ICU-AW）组（MRC < 48 分）和非 ICU-AW 组（MRC ≥ 48 分）：研究包括 47 名 ICU-AW 和 50 名非 ICU-AW 患者。两组患者在年龄、MRC评分、白蛋白水平、c反应蛋白、降钙素基因、脑钠肽、尿素氮、肌酐、机械通气时间、ICU住院时间和住院时间等方面存在显著差异（p < 0.05）。在 ICU-AW 组中，神经传导检查显示传导速度缓慢、波幅减小，严重病例的运动和感觉电位完全丧失。多变量逻辑分析确定低血清白蛋白水平和 MRC 评分是潜在的 ICU-AW 风险因素：本研究表明，低血清白蛋白水平和 MRC 评分可能会导致 ICU-AW 风险。ICU-AW 组表现出不同程度的周围神经损伤和肌电图传导速度缓慢。此外，严重的全身炎症反应、肾功能、脑钠肽水平、长期机械通气和周围神经损伤可能与 ICU-AW 相关。后续研究对于进一步了解这些复杂的相互作用至关重要：ICU获得性乏力危险因素重症监护治疗呼吸衰竭肌电图

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

5.30

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.