A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit-Acquired Weakness.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_BD8A7C8514DB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit-Acquired Weakness.
Journal
Medicina
Author(s)
Klawitter F., Oppitz M.C., Goettel N., Berger M.M., Hodgson C., Weber-Carstens S., Schaller S.J., Ehler J.
ISSN
1648-9144 (Electronic)
ISSN-L
1010-660X
Publication state
Published
Issued date
08/08/2022
Peer-reviewed
Oui
Volume
58
Number
8
Pages
1068
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Background and Objectives: Intensive care unit-acquired weakness (ICU-AW) is one of the most frequent neuromuscular complications in critically ill patients. We conducted a global survey to evaluate the current practices of diagnostics, treatment and prevention in patients with ICU-AW. Materials and Methods: A pre-survey was created with international experts. After revision, the final survey was endorsed by the European Society of Intensive Care Medicine (ESICM) using the online platform SurveyMonkey®. In 27 items, we addressed strategies of diagnostics, therapy and prevention. An invitation link was sent by email to all ESICM members. Furthermore, the survey was available on the ESICM homepage. Results: A total of 154 healthcare professionals from 39 countries participated in the survey. An ICU-AW screening protocol was used by 20% (28/140) of participants. Forty-four percent (62/141) of all participants reported performing routine screening for ICU-AW, using clinical examination as the method of choice (124/141, 87.9%). Almost 63% (84/134) of the participants reported using current treatment strategies for patients with ICU-AW. The use of treatment and prevention strategies differed between intensivists and non-intensivists regarding the reduction in sedatives (80.0% vs. 52.6%, p = 0.002), neuromuscular blocking agents (76.4% vs. 50%, p = 0.004), corticosteroids (69.1% vs. 37.2%, p < 0.001) and glycemic control regimes (50.9% vs. 23.1%, p = 0.002). Mobilization and physical activity are the most frequently reported treatment strategies for ICU-AW (111/134, 82.9%). The availability of physiotherapists (92/134, 68.7%) and the lack of knowledge about ICU-AW within the medical team (83/134, 61.9%) were the main obstacles to the implementation of the strategies. The necessity to develop guidelines for the screening, diagnosing, treatment and prevention of ICU-AW was recognized by 95% (127/133) of participants. Conclusions: A great heterogeneity regarding diagnostics, treatment and prevention of ICU-AW was reported internationally. Comprehensive guidelines with evidence-based recommendations for ICU-AW management are needed.
Keywords
Critical Illness/therapy, Humans, Intensive Care Units, Muscle Weakness/etiology, Muscle Weakness/prevention & control, Respiration, Artificial, Surveys and Questionnaires, critical care, critical illness myopathy, critical illness polyneuropathy, neuromuscular diseases, surveys and questionnaires
Pubmed
Web of science
Open Access
Yes
Create date
06/09/2022 11:55
Last modification date
23/01/2024 8:33
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