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已发表论文
ICU 获得性肌无力的风险因素、诊断难题及新兴治疗策略：简要综述
Authors Zhang X , Wang Z, Wang J, Wu F, Xia L, Shi S, Zhu M, Zhuang J
Received 14 August 2025
Accepted for publication 4 November 2025
Published 28 November 2025 Volume 2025:18 Pages 7769—7778
DOI https://doi.org/10.2147/JMDH.S560139
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr David C. Mohr
Xiaojie Zhang,1 Zixuan Wang,1 Jing Wang,1 Fei Wu,2 Le Xia,2 Suqin Shi,2 Min Zhu,2 Jinqiang Zhuang2
1School of Nursing, Faculty of Medicine, Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China; 2Emergency Intensive Care Unit (EICU), The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China
Correspondence: Jinqiang Zhuang, Emergency Intensive Care Unit (EICU), The First Affiliated Hospital of Yangzhou University, No. 45 Taizhou Road, Guangling District, Yangzhou, Jiangsu, People’s Republic of China, Email zjq7642807@163.com
Abstract: Intensive care unit-acquired weakness (ICU-AW) is a common complication in critically ill patients, associated with multiple risk factors and significantly impacting long-term patient outcomes. Currently, early diagnosis remains a key challenge in managing ICU-AW: clinical scales are limited by subjectivity, while muscle ultrasound and emerging biomarkers (such as the creatinine/cystatin C ratio, miR-451a, and MuRF1), though showing potential for early identification, have not yet been widely adopted in clinical practice. In terms of management, prevention is paramount. The ABCDEF bundle emphasizes early mobilization (initiated within 24– 72 hours), while nutritional strategies targeting molecular pathways (such as HMB and ω-3 fatty acids) help regulate protein metabolism balance. Novel targeted therapies (eg, the myostatin inhibitor Bimagrumab) have demonstrated potential to increase muscle mass in clinical trials. Currently, early diagnosis remains the critical barrier. This review aims to synthesize the latest evidence on the risk factors, diagnostic challenges, and management strategies for ICU-AW, providing insights for clinical practice. It also underscores the need for future research to focus on developing highly sensitive diagnostic tools, optimizing preventive strategies, and promoting the clinical translation of targeted therapies. Ultimately, this will help establish a comprehensive and precise multi-level intervention framework to improve patient outcomes.
Keywords: intensive care unit-acquired weakness, neuroinflammation markers, risk factors, assessment
1School of Nursing, Faculty of Medicine, Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China; 2Emergency Intensive Care Unit (EICU), The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China
Correspondence: Jinqiang Zhuang, Emergency Intensive Care Unit (EICU), The First Affiliated Hospital of Yangzhou University, No. 45 Taizhou Road, Guangling District, Yangzhou, Jiangsu, People’s Republic of China, Email zjq7642807@163.com
Abstract: Intensive care unit-acquired weakness (ICU-AW) is a common complication in critically ill patients, associated with multiple risk factors and significantly impacting long-term patient outcomes. Currently, early diagnosis remains a key challenge in managing ICU-AW: clinical scales are limited by subjectivity, while muscle ultrasound and emerging biomarkers (such as the creatinine/cystatin C ratio, miR-451a, and MuRF1), though showing potential for early identification, have not yet been widely adopted in clinical practice. In terms of management, prevention is paramount. The ABCDEF bundle emphasizes early mobilization (initiated within 24– 72 hours), while nutritional strategies targeting molecular pathways (such as HMB and ω-3 fatty acids) help regulate protein metabolism balance. Novel targeted therapies (eg, the myostatin inhibitor Bimagrumab) have demonstrated potential to increase muscle mass in clinical trials. Currently, early diagnosis remains the critical barrier. This review aims to synthesize the latest evidence on the risk factors, diagnostic challenges, and management strategies for ICU-AW, providing insights for clinical practice. It also underscores the need for future research to focus on developing highly sensitive diagnostic tools, optimizing preventive strategies, and promoting the clinical translation of targeted therapies. Ultimately, this will help establish a comprehensive and precise multi-level intervention framework to improve patient outcomes.
Keywords: intensive care unit-acquired weakness, neuroinflammation markers, risk factors, assessment