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A Predictive Nomogram for Intensive Care-Acquired Weakness after Cardiopulmonary Bypass
Fuxiu Zhong1, Haoruo Zhang2, Yanchun Peng3
1Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China.
Summary
Intensive care unit-acquired weakness (ICUAW) affects over 50% of patients post-cardiopulmonary bypass (CPB). Key risk factors include high BMI, poor NYHA class, and prolonged surgery, enabling a new predictive nomogram.
Area of Science:
- Critical Care Medicine
- Cardiac Surgery
- Neurology
Background:
- Intensive care unit-acquired weakness (ICUAW) significantly impacts patient outcomes following cardiopulmonary bypass (CPB).
- Identifying risk factors for ICUAW post-CPB is crucial for improving patient prognosis.
- Current understanding of ICUAW risk factors after CPB is limited.
Purpose of the Study:
- To investigate the risk factors associated with ICUAW in patients undergoing CPB surgery.
- To develop and validate a predictive nomogram for ICUAW after CPB.
Main Methods:
- Prospective cohort study of 473 patients undergoing CPB.
- Assessment of baseline characteristics, preoperative labs, and intra/postoperative variables.
- Bedside ultrasound of lower limb muscles compared pre- and post-CPB; logistic regression for risk factor analysis.
Main Results:
- Over 50% of patients developed ICUAW post-CPB.
- Independent risk factors identified: BMI, NYHA class, lactate, albumin, aortic clamping time, operation time, and APACHE II score.
- The developed nomogram demonstrated good predictive accuracy (AUC 0.811).
Conclusions:
- High BMI, poor NYHA class, elevated lactate, low albumin, and longer surgical/clamping times are significant risk factors for ICUAW post-CPB.
- The study presents a robust and user-friendly nomogram for clinical decision-making in predicting ICUAW.
- Early identification and management of these risk factors can potentially mitigate ICUAW development.
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