Sepsis-induced neuromuscular dysfunction: A systematic review with meta-analysis

Area of Science:

• Critical Care Medicine
• Neurology
• Infectious Diseases

Background:

• Sepsis-induced neuromuscular dysfunction (SIND) is a frequent yet underrecognized complication in critically ill patients.
• SIND contributes to extended intensive care unit (ICU) stays, increased morbidity, and long-term functional deficits.
• The pathophysiology of SIND is complex, involving host factors, disease severity, and treatments.

Purpose of the Study:

• To systematically identify and classify risk factors associated with SIND in septic patients.
• To estimate the pooled prevalence of SIND across existing clinical studies.

Main Methods:

• Systematic review and meta-analysis adhering to PRISMA 2020 guidelines.
• Searched Medline, BMC, Cochrane Library, and Google Scholar for relevant studies.
• Included 14 studies with 596 adult sepsis patients; risk factors categorized into seven domains and stratified as modifiable/non-modifiable.

Main Results:

• Pooled prevalence of SIND was 60% (95% CI: 50-70%), with significant heterogeneity.
• ICU-acquired neuromuscular dysfunction prevalence was 70% (95% CI: 60-80%), while direct sepsis-related damage was 9% (95% CI: 4-19%).
• Critical illness polyneuropathy was the most common SIND manifestation, strongly linked to modifiable and non-modifiable risk factors.

Conclusions:

• SIND is a highly prevalent and multifactorial complication of sepsis.
• Early identification of risk factors, especially modifiable ones, is crucial for SIND prevention.
• Targeted preventive strategies can potentially improve clinical outcomes for critically ill patients with sepsis.