[Research progress on ICU-acquired weakness in patients with sepsis]

The incidence of ICU-acquired weakness (ICU-AW) in patients with sepsis is relatively high, which can lead to symmetrical atrophy of skeletal muscle, loss of strength and abnormal muscle regeneration and repair. In severe cases, it can cause diaphragmatic involvement, seriously affecting respiratory function and thus the short-term and long-term prognosis of patients. The pathogenesis of ICU-AW in patients with sepsis is complex, mainly involving dysregulation of inflammatory response, neuromuscular conduction disorder, abnormal muscle protein production and decomposition, and reduction of muscle satellite cell (MuSC). There are multiple risk factors, including the patient's own condition, sepsis-induced inflammatory response and multiple organ failure, mechanical ventilation, sedation and analgesia, glucocorticoids, antibacterial drugs, etc. Diagnosis mainly relies on subjective and objective assessment of skeletal muscle and diaphragm, including manual muscle strengthen testing (MMT), handgrip dynamometry (HGD), physical function ICU test (PFIT), muscle electrophysiological examination, muscle ultrasound examination, etc. The treatment usually involves a comprehensive approach including controlling sepsis, early rehabilitation activities, bundle management, neuromuscular electrical stimulation, nutritional support, etc. Integrated traditional Chinese and Western medicine has also shown efficacy. This article reviews the research progress on ICU-AW in patients with sepsis in terms of pathogenesis, risk factors, diagnosis and treatment, aiming to emphasize the value and limitations of ICU-AW in the early clinical diagnosis and treatment of patients with sepsis.