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Sepsis-induced neuromuscular dysfunction affects 60% of ICU adults, pooled meta-analysis findsMore than half of sepsis patients experience muscle weakness
Journal of infection and public healthPublished August 3, 2026Study authors: Becerra Álvaro, Rebolledo Nicolás, Soto Felipe, Valenzuela-Fuenzalida Juan José, Loaiza-Giraldo Jess…PubMed ↗DOI ↗Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic
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Key Takeaway
Recognize that SIND affects 60% of septic ICU patients; early risk factor identification may guide prevention.
This meta-analysis pooled data from 596 adult patients with sepsis in intensive care units to estimate the prevalence of sepsis-induced neuromuscular dysfunction (SIND) and related neuromuscular complications. The analysis reports a pooled SIND prevalence of 60% (95% CI 50-70%), indicating that SIND is a common complication in this population. Additionally, ICU-acquired neuromuscular dysfunction was present in 70% (95% CI 60-80%), while direct neuromuscular damage attributable to sepsis was estimated at 9% (95% CI 4-19%).
The authors emphasize that SIND is a highly prevalent and multifactorial complication of sepsis. They note substantial heterogeneity in SIND prevalence across studies, which limits the precision of the pooled estimates. The analysis did not report on adverse events, funding sources, or follow-up duration.
Given the observational nature of the included studies, the findings are associative and do not establish causation. The authors suggest that early recognition of risk factors, particularly modifiable ones, may support targeted preventive strategies and improve clinical outcomes in critically ill patients. However, the substantial heterogeneity and lack of reported details warrant cautious interpretation.
For clinicians, this meta-analysis underscores the high burden of neuromuscular dysfunction in septic ICU patients and the potential value of early risk factor identification. Further research is needed to clarify modifiable factors and effective preventive interventions.
How this fits prior evidence
This meta-analysis extends prior coverage by quantifying the prevalence of sepsis-induced neuromuscular dysfunction in ICU adults, complementing earlier findings that sepsis is a significant risk factor for thrombocytopenia and that factors like age, male sex, low BMI, and comorbidities increase sepsis incidence. It also aligns with the recognition of sepsis as a systemic inflammatory condition, though it does not address therapeutic targets like HMGB1/LPS interactions. The high prevalence of SIND (60%) underscores the need for early recognition, consistent with prior emphasis on modifiable risk factors.
When a patient falls into a state of sepsis, their body faces an extreme and dangerous response to infection. One of the hardest parts for patients to recover from is the loss of muscle function. This condition, known as SIND, can make it very difficult for people in intensive care units to move or breathe on their own.
Researchers looked at data from 596 adult patients to see how common this issue really is. They found that 60% of these patients experienced sepsis-induced neuromuscular dysfunction. While some muscle issues are caused by the general stress of being in an intensive care unit, only about 9% were linked directly to the damage caused by the sepsis infection itself.
Because there is so much variety in how this condition shows up among different people, it can be hard to predict exactly who will be affected. However, identifying these risks early could help doctors create better plans to protect a patient's muscle strength during their most critical moments.
What this means for you:
About 60% of adults with sepsis experience significant muscle and nerve dysfunction in the intensive care unit.
Common questions
How common is muscle weakness in patients with sepsis?
The study found that 60% of adult patients with sepsis experienced a condition called SIND. This means more than half of the patients looked at in this report had some form of muscle and nerve dysfunction caused by their infection.
Is all muscle weakness in the ICU caused by sepsis?
No, not all muscle issues are from the infection itself. While 60% of patients had sepsis-related muscle problems, only about 9% of cases were found to be direct damage caused specifically by the sepsis.
What is SIND?
SIND stands for sepsis-induced neuromuscular dysfunction. It is a condition where the body's muscles and nerves do not work correctly because of a severe infection. Identifying it early can help doctors create better prevention plans for patients.
INTRODUCTION: Sepsis-induced neuromuscular dysfunction (SIND) is a common but underrecognized complication in critically ill patients, contributing to prolonged intensive care unit (ICU) stays, increased morbidity, and long-term functional impairment. Its pathophysiology is multifactorial, involving interactions among host factors, disease severity, and therapeutic interventions.
OBJECTIVE: To systematically identify and classify risk factors associated with SIND in septic patients and to estimate its pooled prevalence across clinical studies.
METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD42024577234). Databases; Medline, BMC, Cochrane Library, and Google Scholar, were searched for relevant studies. Fourteen studies including 596 adult patients with sepsis were eligible. Risk factors were categorized into seven clinical domains and further stratified as modifiable or non-modifiable. Pooled prevalence estimates were calculated using a random-effects model (DerSimonian-Laird method).
RESULTS: A total of 40 clinical parameters were identified and grouped into seven categories: baseline characteristics, organ failure, disease severity indices, medical procedures, plasma biomarkers, pharmacological therapy, and length of stay. The pooled prevalence of SIND was 60% (95% CI: 50-70%), with substantial heterogeneity. ICU-acquired neuromuscular dysfunction showed a prevalence of 70% (95% CI: 60-80%), whereas direct neuromuscular damage attributable to sepsis was lower (9%, 95% CI: 4-19%). Critical illness polyneuropathy was the most frequently reported entity and demonstrated strong associations with both modifiable and non-modifiable risk factors.
CONCLUSION: SIND is a highly prevalent and multifactorial complication of sepsis. Early recognition of risk factors-particularly modifiable ones-may support targeted preventive strategies and improve clinical outcomes in critically ill patients.
