The rate and assessment of muscle wasting during critical illness: a systematic review and meta-analysis

被引:148
作者
Fazzini, Brigitta [1 ]
Maerkl, Tobias [2 ]
Costas, Christos [3 ]
Blobner, Manfred [4 ,5 ,6 ]
Schaller, Stefan J. [4 ,5 ]
Prowle, John [1 ,3 ]
Puthucheary, Zudin [1 ,3 ]
Wackerhage, Henning [2 ]
机构
[1] Barts Hlth NHS Trust, Royal London Hosp, Adult Crit Care Unit, London, England
[2] Tech Univ Munich, Dept Sports & Hlth Sci, Exercise Biol Grp, Munich, Germany
[3] Queen Mary Univ London, William Harvey Res Inst, London, England
[4] Tech Univ Munich, Sch Med, Dept Anesthesiol & Intens Care Munich, Munich, Germany
[5] Charite Univ Med Berlin, Dept Anesthesiol Operat Intens Care Med CVK, CCM, Berlin, Germany
[6] Humboldt Univ, Dept Anesthesiol & Operat Intens Care Med CVK, CCM, Berlin, Germany
关键词
Intensive care unit; Critical illness; Muscle wasting; Muscle atrophy; ICU-acquired weakness; ICU-AW; INTENSIVE-CARE-UNIT; CROSS-SECTIONAL AREA; ACQUIRED WEAKNESS; ILL PATIENTS; RISK-FACTORS; MECHANICAL VENTILATION; LAYER THICKNESS; POLYNEUROPATHY; MYOPATHY; ULTRASOUND;
D O I
10.1186/s13054-022-04253-0
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Patients with critical illness can lose more than 15% of muscle mass in one week, and this can have long-term detrimental effects. However, there is currently no synthesis of the data of intensive care unit (ICU) muscle wasting studies, so the true mean rate of muscle loss across all studies is unknown. The aim of this project was therefore to systematically synthetise data on the rate of muscle loss and to identify the methods used to measure muscle size and to synthetise data on the prevalence of ICU-acquired weakness in critically ill patients. Methods: We conducted a systematic literature search of MEDLINE, PubMed, AMED, BNI, CINAHL, and EMCARE until January 2022 (International Prospective Register of Systematic Reviews [PROSPERO] registration: CRD420222989540. We included studies with at least 20 adult critically ill patients where the investigators measured a muscle mass-related variable at two time points during the ICU stay. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and assessed the study quality using the Newcastle-Ottawa Scale. Results: Fifty-two studies that included 3251 patients fulfilled the selection criteria. These studies investigated the rate of muscle wasting in 1773 (55%) patients and assessed ICU-acquired muscle weakness in 1478 (45%) patients. The methods used to assess muscle mass were ultrasound in 85% (n = 28/33) of the studies and computed tomography in the rest 15% (n = 5/33). During the first week of critical illness, patients lost every day -1.75% (95% CI -2.05, -1.45) of their rectus femoris thickness or -2.10% (95% CI -3.17, -1.02) of rectus femoris cross-sectional area. The overall prevalence of ICU-acquired weakness was 48% (95% CI 39%, 56%). Conclusion: On average, critically ill patients lose nearly 2% of skeletal muscle per day during the first week of ICU admission.
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页数:26
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