Panahi Ali, Malekmohammad Majid, Soleymani Fereshteh, Hashemian Seyed Mohammadreza
Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Lung Transplantation Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tanaffos. 2020 Jul;19(3):250-255.
Intensive care unit acquired weakness (ICUAW) is a known complication in ICU patients, especially in those with severe underlying diseases. The cause and pathogenesis of ICUAW are still unknown. This study examined the incidence rate of ICUAW in intensive care units (ICUs) of the Masih-Daneshvari Hospital.
This descriptive-comparative study was conducted on 160 patients admitted in the ICUs, including an acute respiratory infectious ICU (TB-ICU) and medical ICU. The total number of patients was 80 in each of the ICUs. Demographic information was obtained from the patients after the initial examination and Medical Research Council (MRC) score was done on daily basis. EMG was performed on the 2 and 8 days of the admission. ICUAW diagnosis was used in cases with MRC scores under 48.
Among the patients, 68.6% were male and the mean age was 59.13±18. 68 years. The final outcomes were 48.4% mortality and 51.6% discharge, which were 41% and 59% in the TB-ICU and 56.7% and 43.3% in the medical ICU, respectively. By defining electromyography as the gold standard, the sensitivity and specificity of ICUAW diagnosis based on the MRC score definition were about 70% and 83%, respectively. The comparison ICUAW patients in the two ICUs in terms of mortality showed no significant difference between them.
It is concluded that nearly half of ICU-admitted patients develop ICUAW that causes a higher mortality rate. Therefore, new plans should be developed to reduce the rate of ICUAW and subsequent death, as well as other possible morbidities.
重症监护病房获得性肌无力（ICUAW）是重症监护病房患者已知的并发症，尤其是患有严重基础疾病的患者。ICUAW的病因和发病机制仍不清楚。本研究调查了马西-达内什瓦里医院重症监护病房（ICU）中ICUAW的发病率。
本描述性比较研究对160例入住ICU的患者进行，包括急性呼吸道感染ICU（结核病ICU）和内科ICU。每个ICU的患者总数为80例。在初次检查后从患者处获取人口统计学信息，并每天进行医学研究委员会（MRC）评分。在入院第2天和第8天进行肌电图检查。MRC评分低于48分的病例被诊断为ICUAW。
患者中68.6%为男性，平均年龄为59.13±18.68岁。最终结局为死亡率48.4%，出院率51.6%，结核病ICU分别为41%和59%，内科ICU分别为56.7%和43.3%。以肌电图检查为金标准，基于MRC评分定义的ICUAW诊断的敏感性和特异性分别约为70%和83%。两个ICU中ICUAW患者的死亡率比较显示差异无统计学意义。
得出的结论是，近一半入住ICU的患者会发生ICUAW，这会导致更高的死亡率。因此，应制定新的计划以降低ICUAW的发生率及随后的死亡率，以及其他可能的发病率。
