• Felix Klawitter, Friederike Laukien, Dagmar-C Fischer, Anja Rahn, Katrin Porath, Lena Danckert, Rika Bajorat, Uwe Walter, Robert Patejdl, and Johannes Ehler.
• Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, Rostock University Medical Center, Rostock, 18057, Germany. felix.klawitter@med.uni-rostock.de.
• Neurocrit Care. 2024 Jul 9.

BackgroundThe diagnosis of intensive care unit (ICU)-acquired weakness (ICUAW) and critical illness neuromyopathy (CINM) is frequently hampered in the clinical routine. We evaluated a novel panel of blood-based inflammatory, neuromuscular, and neurovascular biomarkers as an alternative diagnostic approach for ICUAW and CINM.MethodsPatients admitted to the ICU with a Sequential Organ Failure Assessment score of ≥ 8 on 3 consecutive days within the first 5 days as well as healthy controls were enrolled. The Medical Research Council Sum Score (MRCSS) was calculated, and motor and sensory electroneurography (ENG) for assessment of peripheral nerve function were performed at days 3 and 10. ICUAW was defined by an MRCSS < 48 and CINM by pathological ENG alterations, both at day 10. Blood samples were taken at days 3, 10, and 17 for quantitative analysis of 18 different biomarkers (white blood cell count, C-reactive protein, procalcitonin, C-terminal agrin filament, fatty-acid-binding protein 3, growth and differentiation factor 15, syndecan 1, troponin I, interferon-γ, tumor necrosis factor-α, interleukin-1α [IL-1α], IL-1β, IL-4, IL-6, IL-8, IL-10, IL-13, and monocyte chemoattractant protein 1). Results of the biomarker analysis were categorized according to the ICUAW and CINM status. Clinical outcome was assessed after 3 months.ResultsBetween October 2016 and December 2018, 38 critically ill patients, grouped into ICUAW (18 with and 20 without) and CINM (18 with and 17 without), as well as ten healthy volunteers were included. Biomarkers were significantly elevated in critically ill patients compared to healthy controls and correlated with disease severity and 3-month outcome parameters. However, none of the biomarkers enabled discrimination of patients with and without neuromuscular impairment, irrespective of applied classification.ConclusionsBlood-based biomarkers are generally elevated in ICU patients but do not identify patients with ICUAW or CINM.Trial RegistrationClinicalTrials.gov identifier: NCT02706314.© 2024. The Author(s).

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