Abstract
Objective To identify the risk factors of ICU-acquired weakness(ICU-AW)in mechanically ventilated patients,pro-viding evidence for clinical intervention strategies.Methods Databases including CNKI,WanFang Database,VIP,Chinese Biomed-ical Literature Database(CBM),PubMed,Scopus,Embase,Web of Science,the Cochrane Library,and others were searched for co-hort or case-control studies on the development of ICU-AW in mechanically ventilated patients from inception to December 1,2024.The Medical Research Council Score(MRC-score)recommended by the American Thoracic Society in 2014 was used to eval-uate ICU-AW diagnosis,with the occurrence of ICU-AW as the outcome.Two researchers trained in evidence-based methods conduc-ted preliminary and full-text screening according to inclusion/exclusion criteria.Discrepancies were resolved by consulting a third re-searcher.Meta-analysis was performed on studies meeting quality criteria,and funnel plots were used to assess publication bias.Results A total of 22 studies.Meta-analysis identified 21 risk factors significantly associated with ICU-AW(P＜0.05),including age,infection,duration of MODS,sepsis,and cerebrovascular disease.Factors unrelated to ICU-AW included female sex,diabetes,mi-dazolam,BMI,and propofol(P＞0.05).Funnel plot analysis for age,female sex,sepsis,and APACHE Ⅱ score showed a symmetri-cal inverted funnel distribution,indicating minimal publication bias.Conclusion Risk factors for ICU-AW in mechanically ventila-ted patients include age,blood urea level,infection,glucocorticoid therapy,duration of MODS,neuromuscular blocker use,continuous renal replacement therapy,glycoside use,sepsis,APACHE Ⅱ Score,norepinephrine use,SOFA score,delirium,hyperglycemia,trach-eotomy,vasoactive drug use,sedative use,parenteral nutrition,cerebrovascular disease,and immobilization.关键词
机械通气/ICU获得性衰弱/危险因素Key words
mechanical ventilation/ICU-acquired weakness/risk factors
