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Diagnostic Criteria for ICU Acquired Weakness (ICUAW)

Purpose: To identify a patient with ICU acquired weakness using the criteria of Stevens et al.

Description

Stevens et al listed criteria for the diagnosis of ICU acquired weakness (ICUAW) as the first step in evaluating a patient with intensive care unit-acquired weakness. The authors are from the Johns Hopkins University, Uniformed Services University of Health Sciences, Ohio State University, Centre Hospitalier de Poissy-Saint-Germain and University of Versailles Saint-Quentin en Yvelines Garches.


 

Diagnostic criteria:

(1) generalized muscle weakness starting after the onset of a critical illness

(2) diffuse weakness that is symmetric and flaccid but which usually spares muscles supplied by cranial nerves

(3) exclusion of causes for generalized weakness that are not related to the underyling critical illness

(4) MRC sumscore < 48 (out of 60) on 2 or more occasions separated by more than 24 hours

(5) dependence on mechanical ventilation

 

where:

• An alternative to the MRC sumscore is a mean MRC score < 4 in all testable muscle groups on 2 or more occasions separated by more than 24 hours.

• An example of cranial nerve sparing is intact facial grimacing.

 

Minimum criteria for ICUAW:

(1) presence of 1, 2 and 3

(2) presence of 4 or 5

 


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Specialty

Objective

ICD-10