Abstract
Purpose: Intensive Care Unit Acquired Weakness (ICUAW) is a condition marked by neuromuscular dysfunction that leads to acute generalized weakness, commonly observed among critically ill patients. During their stay in the ICU, they often experience a reduction in peripheral muscle strength; notably, respiratory muscle weakness occurs at twice the rate of limb muscle weakness in this population. With more patients surviving ICU admissions but facing long-term impairments that can lead to unemployment and disability, further investigation into these outcomes is essential. Focusing on handgrip strength (HGS) and respiratory muscle force at ICU discharge, the study aims to determine if HGS and respiratory muscle force are independent markers for ICUAW development.
Methods: A prospective cohort study with a consecutive sampling of 407 adult patients free of systemic weakness from six National Taiwan University Hospital ICUs before their index hospitalization. The Medical Research Council sum score (MRC) was used to screen ICUAW. The handgrip strength (HGS) and maximum inspiratory pressure (MIP) were evaluated on the ICU discharge day.
Results: Of the 406 patients, predominantly male (65.1%), the mean age was 69.02±13.4 years old. Acute respiratory failure was the majority indication of admission to ICU. Upon ICU discharge, all ICU survivors were liberated from mechanical ventilation. Among patients who completed the MRC test (n=275), ICUAW was identified in 22.5% of survivors. A significant association exists between reduced HGS and MIP with ICUAW development. For every one kilogram decrease in HGS, the risk of developing ICU-AW increases by 1.14 times (adjusted odds ratio [aOR], 1.14; 95% confidence interval [CI]: 1.02-1.27, p = .17). Similarly, a one cmH2O reduction in MIP was associated with a 1.06-fold higher risk of developing ICUAW (aOR, 1.06; 95% CI: 1.01-1.11, p = .17).
Conclusions: The incidence of ICUAW was 22.5% in our study, slightly lower than in the previous report. Those affected experience a significant decrease in handgrip strength and respiratory muscle force, associated with higher ICUAW risks. The findings suggest that both HGS and MIP could serve as markers to ICUAW, providing potential for early and more accessible (relative to MRC manual testing) screens and serving as targets for improvement.
Notes
References:
Kramer CL. Intensive Care Unit-Acquired Weakness. Neurol Clin. 2017;35(4):723-736. doi:10.1016/j.ncl.2017.06.008
Siao SF, Yen YH, Yu YF, Zong SL, Chen CC. [Intensive Care Unit-Acquired Weakness]. Hu Li Za Zhi. 2020;67(3):6-13. doi:10.6224/JN.202006_67(3).02
Tzanis G, Vasileiadis I, Zervakis D, et al. Maximum inspiratory pressure, a surrogate parameter for the assessment of ICU-acquired weakness. BMC Anesthesiol. 2011;11:14. doi:10.1186/1471-2253-11-14
Van Aerde N, Meersseman P, Debaveye Y, et al. Five-year impact of ICU-acquired neuromuscular complications: a prospective, observational study. Intensive Care Med. 2020;46(6):1184-1193. doi:10.1007/s00134-020-05927-5
Yamada K, Kitai T, Iwata K, et al. Predictive factors and clinical impact of ICU-acquired weakness on functional disability in mechanically ventilated patients with COVID-19. Heart Lung. 2023;60:139-145. doi:10.1016/j.hrtlng.2023.03.008
Sigma Membership
Lambda Beta at-Large
Type
Poster
Format Type
Text-based Document
Study Design/Type
Cohort
Research Approach
Other
Keywords:
Acute Care, Primary Care, Sub-acute Care, Intensive Care Unit Acquired Weakness
Recommended Citation
Wu, Meng Shan and Chen, Cheryl Chia-Hui, "Identifying ICU-Acquired Weakness Risk Through Handgrip and Maximum Inspiratory Pressure" (2025). International Nursing Research Congress (INRC). 157.
https://www.sigmarepository.org/inrc/2025/posters_2025/157
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Identifying ICU-Acquired Weakness Risk Through Handgrip and Maximum Inspiratory Pressure
Seattle, Washington, USA
Purpose: Intensive Care Unit Acquired Weakness (ICUAW) is a condition marked by neuromuscular dysfunction that leads to acute generalized weakness, commonly observed among critically ill patients. During their stay in the ICU, they often experience a reduction in peripheral muscle strength; notably, respiratory muscle weakness occurs at twice the rate of limb muscle weakness in this population. With more patients surviving ICU admissions but facing long-term impairments that can lead to unemployment and disability, further investigation into these outcomes is essential. Focusing on handgrip strength (HGS) and respiratory muscle force at ICU discharge, the study aims to determine if HGS and respiratory muscle force are independent markers for ICUAW development.
Methods: A prospective cohort study with a consecutive sampling of 407 adult patients free of systemic weakness from six National Taiwan University Hospital ICUs before their index hospitalization. The Medical Research Council sum score (MRC) was used to screen ICUAW. The handgrip strength (HGS) and maximum inspiratory pressure (MIP) were evaluated on the ICU discharge day.
Results: Of the 406 patients, predominantly male (65.1%), the mean age was 69.02±13.4 years old. Acute respiratory failure was the majority indication of admission to ICU. Upon ICU discharge, all ICU survivors were liberated from mechanical ventilation. Among patients who completed the MRC test (n=275), ICUAW was identified in 22.5% of survivors. A significant association exists between reduced HGS and MIP with ICUAW development. For every one kilogram decrease in HGS, the risk of developing ICU-AW increases by 1.14 times (adjusted odds ratio [aOR], 1.14; 95% confidence interval [CI]: 1.02-1.27, p = .17). Similarly, a one cmH2O reduction in MIP was associated with a 1.06-fold higher risk of developing ICUAW (aOR, 1.06; 95% CI: 1.01-1.11, p = .17).
Conclusions: The incidence of ICUAW was 22.5% in our study, slightly lower than in the previous report. Those affected experience a significant decrease in handgrip strength and respiratory muscle force, associated with higher ICUAW risks. The findings suggest that both HGS and MIP could serve as markers to ICUAW, providing potential for early and more accessible (relative to MRC manual testing) screens and serving as targets for improvement.
Description
The study investigated ICU-Acquired Weakness (ICUAW) in 406 ICU survivors. Handgrip strength (HGS) and maximum inspiratory pressure (MIP) were measured at ICU discharge to evaluate their association with ICUAW development. ICUAW occurred in 22.5% of survivors, with reduced HGS and MIP linked to higher ICUAW risks. Each decrease in HGS and MIP significantly increased ICUAW risk. HGS and MIP may serve as accessible markers for early ICUAW screening and potential intervention targets.