PMID- 35307054
OWN - NLM
STAT- MEDLINE
DCOM- 20220322
LR  - 20220322
IS  - 2095-4352 (Print)
VI  - 34
IP  - 1
DP  - 2022 Jan
TI  - [Diagnostic accuracy of muscle ultrasound and plasma monocyte chemoattractant 
      protein-1 for ICU-acquired weakness in patients with sepsis].
PG  - 12-17
LID - 10.3760/cma.j.cn121430-20211021-01531 [doi]
AB  - OBJECTIVE: To explore the diagnostic accuracy of muscle ultrasound and plasma 
      monocyte chemoattractant protein-1 (MCP-1) for ICU-acquired weakness (ICU-AW) in 
      patients with sepsis. METHODS: A prospective observational study was conducted. 
      Patients with sepsis admitted to the intensive care unit (ICU) of Henan 
      Provincial People's Hospital from April 2021 to October 2021 were enrolled. The 
      demographic data were collected. The enrolled patients were evaluated with 
      Medical Research Council (MRC) score every day until discharged from ICU. During 
      this period, patients with total MRC score < 48 (for two consecutive times and a 
      time interval of 24 hours) were divided into ICU-AW group, those with total MRC 
      score >/= 48 were served as non-ICU-AW group. On the 1st, 4th and 7th day following 
      admission into ICU, ultrasound was used to measure the muscle linear thickness of 
      the rectus femoris (RF-MLT), the cross sectional area of the rectus femoris 
      (RF-CSA) and the muscle linear thickness of the vastus intermedius muscle 
      (VI-MLT). And meanwhile, the plasmas samples of patients were collected to 
      measure MCP-1 concentration by enzyme-linked immunosorbent assay (ELISA). The 
      difference of each index was compared between the ICU-AW group and the non-ICU-AW 
      group. The risk factors of ICU-AW in patients with sepsis were analyzed by binary 
      Logistic regression. Besides, receiver operator characteristic curve (ROC curve) 
      was plotted, the diagnostic value of ultrasound parameters and plasma MCP-1 level 
      for ICU-AW in patients with sepsis was analyzed. RESULTS: A total of 99 septic 
      patients were enrolled, with 68 patients in the ICU-AW group and 31 patients in 
      the non-ICU-AW group. Compared with the patients in the ICU-AW group, the 
      patients in the non-ICU-AW group tended to be older, and had higher sequential 
      organ failure assessment (SOFA) score, higher acute physiology and chronic health 
      evaluation II (APACHE II) score, higher rates of septic shock, higher blood 
      lactic acid and lower Glasgow coma score (GCS). Binary Logistic regression 
      analysis showed that APACHE II score and septic shock were the risk factors of 
      ICU-AW for septic patients [odds ratio (OR) and 95% confidence interval (95%CI) 
      were 1.310 (1.138-1.509) and 0.232 (0.072-0.746), respectively, both P < 0.05]. 
      The RF-MLT, RF-CSA and VI-MLT on the 1st, 4th and 7th ICU day was falling over 
      time. Compared with the patients in the ICU-AW group, the patients in the 
      non-ICU-AW group had smaller RF-MLT on the 7th day [cm: 0.32 (0.22, 0.47) vs. 
      0.45 (0.34, 0.63), P < 0.05] and higher 7-day RF-CSA atrophy rate [25.85% 
      (10.37%, 34.28%) vs. 11.65% (2.28%, 22.41%), P < 0.05]. According to ROC curve 
      analysis, 7-day RF-MLT had diagnostic value for ICU-AW of septic patients. Area 
      under ROC curve (AUC) was 0.688 (95%CI was 0.526-0.849); when the cut-off value 
      was 0.41 cm, the sensitivity and the specificity were 66.7% and 68.4%. The levels 
      of plasma MCP-1 in the ICU-AW group were significantly higher than those in the 
      non-ICU-AW group on the 1st, 4th and 7th day. ROC curve analysis showed that the 
      plasma MCP-1 levels on the 1st, 4th and 7th day played a significant role to 
      diagnose ICU-AW for septic patients, the AUC and 95%CI were 0.732 (0.629-0.836), 
      0.865 (0.777-0.953), 0.891 (0.795-0.986), respectively. When the cut-off values 
      were 206.3, 410.9, 239.5 ng/L, the sensitivity was 87.1%, 64.0%, 82.4%, and the 
      specificity was 54.4%, 96.1%, 86.2%, respectively. CONCLUSIONS: The muscle mass 
      parameters on the 7th day of bedside ultrasound and plasma MCP-1 levels had 
      certain diagnostic values for ICU-AW in patients with sepsis.
FAU - Ding, Mingyue
AU  - Ding M
AD  - Department of Intensive Care Unit, Henan Provincial People's Hospital, Zhengzhou 
      University People's Hospital, Zhengzhou 450003, Henan, China. Corresponding 
      author: Qin Bingyu, Email: nicolasby@126.com.
FAU - Ren, Shengyong
AU  - Ren S
FAU - Dong, Xin
AU  - Dong X
FAU - Wang, Xingwei
AU  - Wang X
FAU - Zhao, Xiafei
AU  - Zhao X
FAU - Qin, Bingyu
AU  - Qin B
LA  - chi
PT  - Journal Article
PT  - Observational Study
PL  - China
TA  - Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
JT  - Zhonghua wei zhong bing ji jiu yi xue
JID - 101604552
RN  - 0 (Chemokine CCL2)
SB  - IM
MH  - *Chemokine CCL2
MH  - Humans
MH  - Intensive Care Units
MH  - Muscle Weakness/diagnosis
MH  - Muscles
MH  - *Sepsis/complications/diagnostic imaging
EDAT- 2022/03/22 06:00
MHDA- 2022/03/23 06:00
CRDT- 2022/03/21 05:30
PHST- 2022/03/21 05:30 [entrez]
PHST- 2022/03/22 06:00 [pubmed]
PHST- 2022/03/23 06:00 [medline]
AID - 10.3760/cma.j.cn121430-20211021-01531 [doi]
PST - ppublish
SO  - Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2022 Jan;34(1):12-17. doi: 
      10.3760/cma.j.cn121430-20211021-01531.