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A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit—Acquired Weakness

Background and Objectives: Intensive care unit-acquired weakness (ICU-AW) is one of the most frequent neuromuscular complications in critically ill patients. We conducted a global survey to evaluate the current practices of diagnostics, treatment and prevention in patients with ICU-AW. Materials and...

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Autores principales: Klawitter, Felix, Oppitz, Marie-Christine, Goettel, Nicolai, Berger, Mette M., Hodgson, Carol, Weber-Carstens, Steffen, Schaller, Stefan J., Ehler, Johannes
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9416039/
https://www.ncbi.nlm.nih.gov/pubmed/36013535
http://dx.doi.org/10.3390/medicina58081068
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author Klawitter, Felix
Oppitz, Marie-Christine
Goettel, Nicolai
Berger, Mette M.
Hodgson, Carol
Weber-Carstens, Steffen
Schaller, Stefan J.
Ehler, Johannes
author_facet Klawitter, Felix
Oppitz, Marie-Christine
Goettel, Nicolai
Berger, Mette M.
Hodgson, Carol
Weber-Carstens, Steffen
Schaller, Stefan J.
Ehler, Johannes
author_sort Klawitter, Felix
collection PubMed
description Background and Objectives: Intensive care unit-acquired weakness (ICU-AW) is one of the most frequent neuromuscular complications in critically ill patients. We conducted a global survey to evaluate the current practices of diagnostics, treatment and prevention in patients with ICU-AW. Materials and Methods: A pre-survey was created with international experts. After revision, the final survey was endorsed by the European Society of Intensive Care Medicine (ESICM) using the online platform SurveyMonkey(®). In 27 items, we addressed strategies of diagnostics, therapy and prevention. An invitation link was sent by email to all ESICM members. Furthermore, the survey was available on the ESICM homepage. Results: A total of 154 healthcare professionals from 39 countries participated in the survey. An ICU-AW screening protocol was used by 20% (28/140) of participants. Forty-four percent (62/141) of all participants reported performing routine screening for ICU-AW, using clinical examination as the method of choice (124/141, 87.9%). Almost 63% (84/134) of the participants reported using current treatment strategies for patients with ICU-AW. The use of treatment and prevention strategies differed between intensivists and non-intensivists regarding the reduction in sedatives (80.0% vs. 52.6%, p = 0.002), neuromuscular blocking agents (76.4% vs. 50%, p = 0.004), corticosteroids (69.1% vs. 37.2%, p < 0.001) and glycemic control regimes (50.9% vs. 23.1%, p = 0.002). Mobilization and physical activity are the most frequently reported treatment strategies for ICU-AW (111/134, 82.9%). The availability of physiotherapists (92/134, 68.7%) and the lack of knowledge about ICU-AW within the medical team (83/134, 61.9%) were the main obstacles to the implementation of the strategies. The necessity to develop guidelines for the screening, diagnosing, treatment and prevention of ICU-AW was recognized by 95% (127/133) of participants. Conclusions: A great heterogeneity regarding diagnostics, treatment and prevention of ICU-AW was reported internationally. Comprehensive guidelines with evidence-based recommendations for ICU-AW management are needed.
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spelling pubmed-94160392022-08-27 A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit—Acquired Weakness Klawitter, Felix Oppitz, Marie-Christine Goettel, Nicolai Berger, Mette M. Hodgson, Carol Weber-Carstens, Steffen Schaller, Stefan J. Ehler, Johannes Medicina (Kaunas) Article Background and Objectives: Intensive care unit-acquired weakness (ICU-AW) is one of the most frequent neuromuscular complications in critically ill patients. We conducted a global survey to evaluate the current practices of diagnostics, treatment and prevention in patients with ICU-AW. Materials and Methods: A pre-survey was created with international experts. After revision, the final survey was endorsed by the European Society of Intensive Care Medicine (ESICM) using the online platform SurveyMonkey(®). In 27 items, we addressed strategies of diagnostics, therapy and prevention. An invitation link was sent by email to all ESICM members. Furthermore, the survey was available on the ESICM homepage. Results: A total of 154 healthcare professionals from 39 countries participated in the survey. An ICU-AW screening protocol was used by 20% (28/140) of participants. Forty-four percent (62/141) of all participants reported performing routine screening for ICU-AW, using clinical examination as the method of choice (124/141, 87.9%). Almost 63% (84/134) of the participants reported using current treatment strategies for patients with ICU-AW. The use of treatment and prevention strategies differed between intensivists and non-intensivists regarding the reduction in sedatives (80.0% vs. 52.6%, p = 0.002), neuromuscular blocking agents (76.4% vs. 50%, p = 0.004), corticosteroids (69.1% vs. 37.2%, p < 0.001) and glycemic control regimes (50.9% vs. 23.1%, p = 0.002). Mobilization and physical activity are the most frequently reported treatment strategies for ICU-AW (111/134, 82.9%). The availability of physiotherapists (92/134, 68.7%) and the lack of knowledge about ICU-AW within the medical team (83/134, 61.9%) were the main obstacles to the implementation of the strategies. The necessity to develop guidelines for the screening, diagnosing, treatment and prevention of ICU-AW was recognized by 95% (127/133) of participants. Conclusions: A great heterogeneity regarding diagnostics, treatment and prevention of ICU-AW was reported internationally. Comprehensive guidelines with evidence-based recommendations for ICU-AW management are needed. MDPI 2022-08-08 /pmc/articles/PMC9416039/ /pubmed/36013535 http://dx.doi.org/10.3390/medicina58081068 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Klawitter, Felix
Oppitz, Marie-Christine
Goettel, Nicolai
Berger, Mette M.
Hodgson, Carol
Weber-Carstens, Steffen
Schaller, Stefan J.
Ehler, Johannes
A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit—Acquired Weakness
title A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit—Acquired Weakness
title_full A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit—Acquired Weakness
title_fullStr A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit—Acquired Weakness
title_full_unstemmed A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit—Acquired Weakness
title_short A Global Survey on Diagnostic, Therapeutic and Preventive Strategies in Intensive Care Unit—Acquired Weakness
title_sort global survey on diagnostic, therapeutic and preventive strategies in intensive care unit—acquired weakness
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9416039/
https://www.ncbi.nlm.nih.gov/pubmed/36013535
http://dx.doi.org/10.3390/medicina58081068
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