Higuchi Tae, Ide Tomomi, Fujino Takeo, Tohyama Takeshi, Nagatomi Yuta, Nezu Tomoyuki, Ikeda Masataka, Hashimoto Toru, Matsushima Shouji, Shinohara Keisuke, Nishihara Masaaki, Iyonaga Takeshi, Akahoshi Tomohiko, Ushijima Tomoki, Shiose Akira, Kinugawa Shintaro, Tsutsui Hiroyuki, Abe Kohtaro
Department of Rehabilitation Medicine, Kyushu University Hospital, Fukuoka, Japan.
Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Fukuoka, Japan.
Sci Rep. 2025 Jan 28;15(1):3535. doi: 10.1038/s41598-025-87381-1.
Intensive care unit-acquired weakness (ICU-AW) is recognized as newly-acquired bilateral muscle weakness, which is a complication of critical illness in the ICU; however, there are no reports on the pathogenesis and early predictors of ICU-AW specifically associated with cardiogenic shock (CS). Therefore, this study aimed to investigate the clinical characteristics of ICU-AW in patients with CS requiring mechanical circulatory support (MCS). This study was a single-center, prospective, and observational study. Patients aged 16 years and older who underwent MCS for CS were included. ICU-AW was diagnosed based on Medical Research Council (MRC) score after awakening. The ICU-AW group included patients with the MRC score < 48 points, and the non-ICU-AW group included those with ≥ 48 points. Twenty-eight cases were enrolled on admission and MRC score was evaluated in 23 cases after awakening. Eleven patients were included in the non-ICU-AW group and 12 patients (52%) were in the ICU-AW group. The ICU-AW group showed a higher prevalence of extracorporeal membrane oxygenation and ventilator use. Creatine kinase, troponin T, interleukin (IL)-15 levels on admission were significantly higher, whereas hemoglobin and albumin levels were significantly lower in the ICU-AW group. A strong negative correlation was observed between the initial MRC scores and IL-15 levels. ICU-AW occurred 52% of patients with CS using MCS, indicating the significance of recognizing and managing this complication for those patients. In addition, IL-15 can be a potential biomarker for the early prediction of ICU-AW.
重症监护病房获得性肌无力（ICU-AW）被认为是新出现的双侧肌肉无力，是重症监护病房危重病的一种并发症；然而，尚无关于与心源性休克（CS）特异性相关的ICU-AW发病机制和早期预测因素的报道。因此，本研究旨在调查需要机械循环支持（MCS）的CS患者中ICU-AW的临床特征。本研究为单中心、前瞻性观察性研究。纳入年龄≥16岁、因CS接受MCS的患者。根据觉醒后医学研究委员会（MRC）评分诊断ICU-AW。MRC评分<48分的患者纳入ICU-AW组，MRC评分≥48分的患者纳入非ICU-AW组。入院时纳入28例患者，23例觉醒后评估MRC评分。非ICU-AW组纳入11例患者，ICU-AW组纳入12例患者（52%）。ICU-AW组体外膜肺氧合和呼吸机使用的发生率更高。ICU-AW组入院时肌酸激酶、肌钙蛋白T、白细胞介素（IL）-15水平显著升高，而血红蛋白和白蛋白水平显著降低。初始MRC评分与IL-15水平呈显著负相关。使用MCS的CS患者中52%发生了ICU-AW，这表明认识和处理该并发症对这些患者具有重要意义。此外，IL-15可能是早期预测ICU-AW的潜在生物标志物。
