Potential diagnostic tools for intensive care unit acquired weakness: A systematic review

Area of Science:

• Critical Care Medicine
• Neurology
• Physical Therapy

Background:

• Intensive care unit-acquired weakness (ICU-AW) is a common complication in critically ill patients, leading to poor outcomes.
• Early diagnosis of ICU-AW is crucial for timely interventions, but diagnostic tools are lacking.
• Existing diagnostic methods for ICU-AW have limitations in accuracy, usability, and acceptance.

Purpose of the Study:

• To comprehensively review diagnostic tools for ICU-AW in critically ill patients.
• To summarize the diagnostic efficacy and limitations of current ICU-AW diagnostic tools.
• To assist healthcare professionals in selecting appropriate diagnostic tools for ICU-AW.

Main Methods:

• Systematic literature search using PRISMA guidelines across major databases (PubMed, Web of Science, EMBASE, Cochrane, CINAHL).
• Inclusion of 38 observational studies published up to July 1, 2024.
• Narrative synthesis due to data heterogeneity; risk of bias assessment performed.

Main Results:

• Gold standards include MRC score, muscle biopsy, and electrophysiologic testing.
• Potential tools include manual muscle testing, imaging, serum markers, and neuromuscular ultrasound.
• Diagnostic accuracy is inconsistent; no single tool is definitive, necessitating combined methods.

Conclusions:

• Current diagnostic tools for ICU-AW have varied strengths and limitations.
• A combination of methods is often required for definitive diagnosis.
• Further research is needed to develop improved and standardized diagnostic tools for ICU-AW.