Predictive factors and clinical impact of ICU-acquired weakness on functional disability in mechanically ventilated patients with COVID-19.
Kanji Yamada, Takeshi Kitai, Kentaro Iwata and 15 others
PMID 37018902WHAT IT FOUND
Half of mechanically ventilated COVID-19 patients developed ICU-acquired weakness, which delayed functional independence to a median of 41 days versus 19 days.
Older age, neuromuscular blockers, pulse steroids, and sepsis were associated with weakness.
Key findings
01ICU-acquired weakness was diagnosed in 51.0% of patients and was associated with delayed functional independence during hospitalization.
02Older age, administration of neuromuscular blocking agents, pulse steroid therapy, and sepsis were significantly associated with the development of ICU-acquired weakness.
03Patients with ICU-acquired weakness had significantly lower functional independence at hospital discharge (27.5%) compared to those without (83.1%).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
The study was single-center and observational, limiting generalizability and preventing causal conclusions about the risk factors. Patients who could not be assessed for ICU-acquired weakness due to communication disorders or severe consciousness issues were excluded, potentially biasing the sample toward those who could communicate. The sample size was relatively small (157 patients), and treatment protocols for COVID-19 may have changed during the study period, affecting consistency. The study did not control for all potential confounders, such as the exact timing or intensity of rehabilitation delivered, which was part of standard care.
Declared interests
The authors declared no conflicts of interest. The research did not receive specific funding from public, commercial, or not-for-profit sectors.
The easy way to misread this
Do not interpret the associations with neuromuscular blockers or steroids as proof that these treatments caused weakness. This is an observational study where these drugs are given to the sickest patients, so the association may reflect disease severity rather than a direct harmful effect of the medication itself.