Cited 44 times since 2017 (5.4 per year) source: EuropePMC Critical care medicine, Volume 45, Issue 6, 1 1 2017, Pages 972-979 Increased Early Systemic Inflammation in ICU-Acquired Weakness; A Prospective Observational Cohort Study. Witteveen E, Wieske L, van der Poll T, van der Schaaf M, van Schaik IN, Schultz MJ, Verhamme C, Horn J, Molecular Diagnosis and Risk Stratification of Sepsis (MARS) Consortium
Objectives
To investigate whether patients who develop ICU-acquired weakness have a different pattern of systemic inflammatory markers compared with critically ill patients who do not develop ICU-acquired weakness.
Design
Prospective observational cohort study.
Setting
Mixed medical-surgical ICU of a tertiary care hospital in the Netherlands.
Patients
Newly admitted critically ill patients, greater than or equal to 48 hours on mechanical ventilation with a nonneurologic ICU admission diagnosis, were included.
Interventions
A panel of systemic inflammatory markers and soluble vascular adhesion molecules were measured in plasma samples of day 0, 2, and 4 after ICU admission. ICU-acquired weakness was diagnosed by manual muscle strength testing as soon as patients were awake and attentive.
Measurements and main results
Ninety-nine of 204 included patients developed ICU-acquired weakness. Principal component regression analysis, adjusted for confounders, showed that principal component 1, mainly loaded with interleukin-6, interleukin-8, interleukin-10, and fractalkine, was significantly higher in patients who developed ICU-acquired weakness (odds ratio, 1.35 [95% CI, 1.18-1.55]). Partial least squares-discriminant analysis also showed that these markers were the most important discriminative markers. Mixed-effects models of these markers showed that ICU-acquired weakness was associated with an independent 1.5- to two-fold increase in these markers.
Conclusions
Systemic inflammation is increased in patients who develop ICU-acquired weakness compared with patients who do not develop ICU-acquired weakness in the first 4 days after ICU admission. This finding is consistent when adjusted for confounders, like disease severity. A group consisting of interleukin-6, interleukin-8, interleukin-10, and fractalkine was identified to be the most important.
