ICU-Acquired Weakness: From Pathophysiology to Management in Critical Care

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

ICU-Acquired weakness is an important and current problem in intensive care. The authors described this problem in a review manuscript. The manuscript has a high educational value.

 

My reflections:

1. Table 1 describes risk factors. Then the authors describe each of the factors. Unfortunately, they do not refer to parenteral nutrition and high lactate level. This should be completed.

 

2. Not all abbreviations used are explained. Some abbreviations are explained twice.

 

3. What do the numbers in Table 2 mean?

 

4. The manuscript is written based on data published in publications analyzed by the authors. The authors should avoid subjective terms such as "in our opinion", "we believe" and the like.

Author Response

1- Table 1 describes risk factors. Then the authors describe each of the factors. Unfortunately, they do not refer to parenteral nutrition and high lactate level. This should be completed.

We added a paragraph regarding this two topics

2. Not all abbreviations used are explained. Some abbreviations are explained twice.

Hope this is ok now

3. What do the numbers in Table 2 mean?

The numbers refer to the articles cited in bibiography, we corrected the table

4. The manuscript is written based on data published in publications analyzed by the authors. The authors should avoid subjective terms such as "in our opinion", "we believe" and the like

We took those parts out

Reviewer 2 Report

Comments and Suggestions for Authors

Dear authors,

The manuscript's topic is very current, indicating complex issues related to severe, frequent complications that can occur in critically ill patients in the intensive care unit. It presents many aspects of intensive care unit-acquired weakness (ICU-AV) characterized by profound and often prolonged muscle weakness in these patients. At the same time, the data presented in the manuscript indicate the need for further research to establish standardized diagnostic protocols and develop targeted treatments for ICU-AV.

Given that the manuscript's topic is important to the professional and scientific public and that great effort has been made to present data from 68 highly representative references, please make corrections to the manuscript following the extension for the review checklist.

I hope you find my comments helpful.

Author Response

Given that the manuscript's topic is important to the professional and scientific public and that great effort has been made to present data from 68 highly representative references, please make corrections to the manuscript following the extension for the review checklist

Thank you for your suggestions, we hope we did a better work in our revised manuscript.

Reviewer 3 Report

Comments and Suggestions for Authors

In this review based on the relevant literature of the last five years, the authors have examined an emerging clinical condition in the field of critical medicine: ICU-Acquired weakness. The latter is described in its predisposing factors, in its pathophysiology, in the diagnosis and in the possible therapeutic approaches. The work appears organic and well argued and can certainly constitute a valid consultation tool both for doctors who are experts in the subject, and for those who, not being fully informed, still wish to have an exhaustive overview of the topic. As my only advice for the authors, I suggest introducing some more information on the real prevalence and incidence reported in the various studies and whether there are geographical differences in the prevalence or reporting of the phenomenon. Overall, an interesting work for the readers of the Journal.

Author Response

I suggest introducing some more information on the real prevalence and incidence reported in the various studies and whether there are geographical differences in the prevalence or reporting of the phenomenon

We have implemented the review with information on the real prevalence and incidence, unfortunately we didn't find  anything regarding the geographical derivation

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Authors,

The corrections made sufficient improvement to warrant publication in Emergency Care and Medicine.