Evaluating dysfunction of diaphragm and weakness due to ICU stay in septic shock patients with or without mechanical ventilation: a clinical study

Abstract

Background:
Septic shock is a critical condition often leading to respiratory failure, necessitating mechanical ventilation in intensive care unit (ICU) patients. Diaphragm dysfunction and ICU-acquired weakness are common complications in such patients, but their prevalence and
association with mechanical ventilation in the context of septic shock remain unclear. This pilot prospective observational study aimed to investigate diaphragm dysfunction and ICU acquired weakness in septic shock patients with or without mechanical ventilation.
Materials and Methods:
We conducted this study at a tertiary hospital over a period from October 2022 to March 2023. A total of 45 septic shock patients were included in the study. Demographic and clinical data were collected, including the need for mechanical ventilation, duration of
mechanical ventilation, and the presence of diaphragm dysfunction and ICU-acquired weakness. Diaphragm dysfunction was assessed using ultrasound, while ICU-acquired weakness was evaluated using clinical criteria and standardized assessments.
Results:
Of the 45 septic shock patients included in the study, 25 (55.6%) required mechanical ventilation. Among mechanically ventilated patients, the average duration of mechanical ventilation was 8.5 ± 3.2 days. Diaphragm dysfunction was observed in 60% of mechanically ventilated patients compared to 20% of non-ventilated patients. ICU-acquired weakness was present in 48% of mechanically ventilated patients and 15% of non-ventilated patients. The difference in the prevalence of both diaphragm dysfunction and ICU-acquired weakness between the two groups was statistically significant (p < 0.05).
Conclusion:
This pilot study suggests a high prevalence of diaphragm dysfunction and ICU-acquired weakness in septic shock patients, with a significantly greater occurrence in those requiring mechanical ventilation. These findings highlight the importance of monitoring and managing diaphragm function and muscle weakness in septic shock patients, especially those on mechanical ventilation, to potentially improve outcomes in this vulnerable population.