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Bedside voluntary and evoked forces evaluation in intensive care unit patients: a narrative review

期刊

CRITICAL CARE
卷 25, 期 1, 页码 -

出版社

BMC
DOI: 10.1186/s13054-021-03567-9

关键词

Intensive care unit-acquired weakness; Skeletal muscle function; Electrical stimulation; Magnetic stimulation; Ergometers

资金

  1. Idex Fellowship

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Around one third of ICU patients develop ICUAW, a condition that is difficult to diagnose and often delayed. Non-invasive electrical and/or magnetic evoked force measurements may be an effective strategy for early characterization and diagnosis of ICUAW.
Around one third of intensive care unit (ICU) patients will develop severe neuromuscular alterations, known as intensive care unit-acquired weakness (ICUAW), during their stay. The diagnosis of ICUAW is difficult and often delayed as a result of sedation or delirium. Indeed, the clinical evaluation of both Medical Research Council score and maximal voluntary force (e.g., using handgrip and/or handheld dynamometers), two independent predictors of mortality, can be performed only in awake and cooperative patients. Transcutaneous electrical/magnetic stimulation applied over motor nerves combined with the development of dedicated ergometer have recently been introduced in ICU patients in order to propose an early and non-invasive measurement of evoked force. The aim of this narrative review is to summarize the different tools allowing bedside force evaluation in ICU patients and the related experimental protocols. We suggest that non-invasive electrical and/or magnetic evoked force measurements could be a relevant strategy to characterize muscle weakness in the early phase of ICU and diagnose ICUAW.

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