Increased Early Systemic Inflammation in ICU-Acquired Weakness; A Prospective Observational Cohort Study.

Area of Science:

• Critical Care Medicine
• Immunology
• Neurology

Background:

• Intensive care unit-acquired weakness (ICU-AW) is a common complication in critically ill patients.
• Systemic inflammation plays a role in critical illness, but its specific association with ICU-AW is not fully understood.

Purpose of the Study:

• To compare systemic inflammatory marker patterns in patients who develop ICU-AW versus those who do not.
• To identify specific inflammatory markers associated with ICU-AW.

Main Methods:

• Prospective observational cohort study in a mixed medical-surgical ICU.
• Measured plasma levels of inflammatory markers and soluble vascular adhesion molecules on days 0, 2, and 4 post-ICU admission.
• Diagnosed ICU-AW using manual muscle strength testing in awake and attentive patients.

Main Results:

• Ninety-nine of 204 patients developed ICU-AW.
• A panel of markers, including interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), and fractalkine, was significantly higher in patients with ICU-AW.
• Adjusted analyses showed ICU-AW was associated with a 1.5- to two-fold increase in these markers.

Conclusions:

• Systemic inflammation is elevated in the first four days of ICU admission for patients who develop ICU-AW.
• Specific inflammatory markers (IL-6, IL-8, IL-10, fractalkine) are key discriminators for ICU-AW, independent of disease severity.
• Increased systemic inflammation is a significant factor in the development of ICU-acquired weakness.