Introduction: Intensive Care Unit-acquired weakness (ICU-AW) is a common and severe complication of intensive care admission. We studied the effect of blood product transfusion (possibly a modifiable risk factor) on ICU-AW.
Methods: Records of blood product transfusion (red blood cell, platelet and plasma) were analyzed in a database from a prospective observational cohort study where newly admitted ICU patients who were mechanically ventilated ≥2 days were included. Manual muscle strength was measured according to the Medical Research Council (MRC) scale, when patients were awake and attentive. ICU–AW was defined as an average MRC score <4.
Results: Of 196 patients, 98 patients (50%) were diagnosed with ICU-AW. A significantly higher odds ratio (OR) for ICU-AW was found in patients receiving red blood cells (OR 2.85, 95% CI 1.58-5.15), plasma (OR 2.38, 95% CI 1.30–4.35) or platelet transfusion (OR 2.09, 95% CI 1.16–3.75) compared to nontransfused patients. The number of red blood cell units (OR 1.07, 95% CI 1.02-1.13) and platelet units (OR 1.24, 95% CI 1.07-1.43) were also associated with ICU-AW. However, when corrected for illness severity, these associations were no longer significant.
Conclusion: The association between transfusion and ICU-AW is explained by illness severity. Risk reducing strategies to prevent development of ICU-AW should focus on other possible risk factors.