The diagnostic value of combining quantitative peripheral muscle ultrasound examination with bioelectrical impedance analysis in assessing intensive care unit-acquired weakness among tumor sepsis patients.

Objective This study aimed to investigate the diagnostic value of ultrasound-measured rectus femoris cross-sectional area (RF-CSA), tibialis anterior muscle thickness (TA-MT), and micro-indicators in bioelectrical impedance analysis (BIA) for diagnosing intensive care unit-acquired weakness (ICU-AW). Methods We conducted a single-center, observational study on patients hospitalized in the ICU of Tianjin Cancer Hospital with tumor-induced sepsis or septic shock. Ultrasonography was used to assess changes in peripheral skeletal muscle (RF-CSA, TA-MT) within 6 hours of sepsis onset and 72 hours after sepsis treatment. BIA was employed to measure micro-component changes in the human body. Statistical analysis was performed to predict the probability of ICU-AW occurrence. Results A total of 41 patients were included, with 17 diagnosed with ICU-AW. Regardless of the final ICU-AW diagnosis, all patients exhibited significant decreases in RF-CSA, TA-MT, skeletal muscle index (SMI), mid-upper arm circumference (MUAC), total body water (TBW), and protein levels. However, patients diagnosed with ICU-AW displayed more pronounced declines. RF-CSA, SMI, protein, and TBW demonstrated higher area under the receiver operating characteristic curves (ROC-AUCs) of 0.762, 0.730, 0.733, and 0.735, respectively, for diagnosing ICU-AW. Moreover, the initial Acute Physiology and Chronic Health Evaluation II (APACHE II) score and Sequential Organ Failure Assessment (SOFA) score exhibited good diagnostic value with ROC-AUCs of 0.768 and 0.716, respectively. In the combined diagnostic model, RF-CSA and SMI had the highest ROC-AUC of 0.849. Conclusion Peripheral muscle ultrasound and bioelectrical impedance analysis can serve as early identification methods for ICU-AW in patients with tumor-related sepsis. Individually, RF-CSA, SMI, protein, and TBW have good diagnostic accuracy for ICU-AW. Additionally, the more easily obtainable APACHE II score and SOFA score show comparable diagnostic value. The combined diagnostic model based on RF-CSA and SMI demonstrated the highest predictive accuracy for ICU-AW.