Critical illness and bone metabolism: where are we now and what is next?

Abstract

Critical illness refers to the clinical signs of severe, variable and life-threatening critical conditions, often accompanied by insufficiency or failure of one or more organs. Bone health of critically ill patients is severely affected during and after ICU admission. Therefore, clinical work should focus on ICU-related bone loss, and early development and implementation of related prevention and treatment strategies: optimized and personalized nutritional support (high-quality protein, trace elements and intestinal prebiotics) and appropriate physiotherapy and muscle training should be implemented as early as possible after ICU admission and discharge. At the same time, the drug regulates excessive metabolism and resists osteoporosis.

Management of endocrinological problems in children on home invasive mechanical ventilation

“…While bone turnover is increasing, the balance between osteoclasts, which are effective in bone resorption, and osteoblasts, which are involved in bone formation, is disturbed. 23 Patients undergoing HIMV may have more than one problem that may adversely affect bone health. Among these, the characteristics of the underlying primary diseases, inactivity, malnutrition, and the drugs they use can be mentioned.…”

“…Among the factors that increase bone loss are activity restriction, inflammation, vitamin D deficiency, malnutrition, use of drugs that have negative effects on bone such as corticosteroids. While bone turnover is increasing, the balance between osteoclasts, which are effective in bone resorption, and osteoblasts, which are involved in bone formation, is disturbed 23 …”

Hypercalcaemia of Immobility in Critically Ill Patients: Case Series

“…In critically ill patients, metabolic bone disease is underappreciated even though critical illness has been linked to accelerated bone loss [1,2]. Metabolic bone disease can also be a manifestation of critical illness presenting as hypercalcaemia in its severe cases [1][2][3].…”

“…In critically ill patients, metabolic bone disease is underappreciated even though critical illness has been linked to accelerated bone loss [1,2]. Metabolic bone disease can also be a manifestation of critical illness presenting as hypercalcaemia in its severe cases [1][2][3]. Increased bone resorption is evident among critically ill patients with markers up to eight times above the reference range from 24 hours of intensive care unit (ICU) admission [4,5].…”