Critical Illness Myopathy and GLUT4

Weber‐Carstens, Steffen; Schneider, Joanna; Wollersheim, Tobias; Assmann, Anke; Bierbrauer, Jeffrey; Marg, Andreas; Hasani, Hadi Al; Chadt, Alexandra; Wenzel, Katrin; Koch, Susanne; Fielitz, Jens; Kleber, Christian; Faust, Katharina; Mai, Knut; Spies, Claudia; Luft, Friedrich C.; Boschmann, Michael; Spranger, Joachim; Spuler, Simone

doi:10.1164/rccm.201209-1649oc

Cited by 99 publications

(82 citation statements)

References 43 publications

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“…It is easy to understand that the abnormal elevation in HbA1c indicates that the control of blood glucose may be not satisfactory, but studies have confirmed that abnormal elevation in blood glucose is an independent risk factor for the poor prognosis of critically ill patients,[11-13] and strict control of blood glucose is one of the target treatments for these patients. [14-16] Our results also indicated that the 28-day mortality of the patients without a medical history of diabetes (29/151, 19.21%) was significantly higher than that of the patients with definite diabetes (15/211, 7.11%) ( P =0.000). Blood glucose control and complications of diabetes were not as satisfactory as those in patients without diabetes, but the prognosis of critical diseases was relatively satisfactory.…”

Section: Discussionsupporting

confidence: 65%

Glycated hemoglobin A1C and diabetes mellitus in critically ill patients

Zhang¹,

Wu²,

Li³

2013

World Journal of Emergency Medicine

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BACKGROUND:Hyperglycemia has been detected in many critically ill patients in the department of emergency medicine. But its mechanism and prognosis have not been well elucidated. In this study, we measured the serum level of glycated hemoglobin A1C (HbA1c) in critically ill patients to evaluate the effects of hyperglycemia on the prognosis of the patients.METHODS:A total of 826 critically ill patients, who had been treated at the Department of Emergency Medicine of Chaoyang Hospital during October 2006 and November 2007, were divided into a diabetes mellitus group (n=184) and a non-diabetes mellitus group (642) according to whether they had diabetes mellitus. Fasting glucose and HbA1c were measured in all patients. Those in the diabetes mellitus group were further assigned to a drug therapy subgroup and a non-drug therapy subgroup; the serum level of HbA1c and its relationship with short-term outcome were evaluated.RESULTS:Fasting glucose increased in 78.8% of the patients (88.6% in the diabetes mellitus group, and 75.9% in the non-diabetes mellitus group, P<0.05), and HbA1c was elevated in 45.5% of the patients (78.3% in the diabetes mellitus group, and 36.1% in the non-diabetes mellitus group, P<0.01). Fasting glucose, HbA1c and 28-day mortality were improved more significantly (P<0.01) in the drug therapy subgroup than in the non-drug therapy subgroup. The 28-day mortality was more significantly different in patients with fasting blood glucose >8.33 mmol/L than in those with fasting blood glucose <8.33 mmol/L.CONCLUSIONS:Hyperglycemia of critically ill patients could not totally attribute to stress response, especially in those who have no history of diabetes mellitus. Prognosis of hyperglycemia may vary among critically ill patients.

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Section: Discussionsupporting

confidence: 65%

Glycated hemoglobin A1C and diabetes mellitus in critically ill patients

Zhang¹,

Wu²,

Li³

2013

World Journal of Emergency Medicine

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“…There are still phases in which patients are not available for active physiotherapy, and these intervals often coincide with intervals of severe illness, acute systemic inflammation, or dependency on norepinephrine for hemodynamic stability. These early periods of critical illness and inflammation are particularly significant in the development of muscle wasting and ICU-AW, as we [6, 14] and others [7] could recently show. Evoked muscle training to avoid immobilization due to EMS can be an option [10–12, 14], but application is labored, often not feasible [15], and in general EMS therapy for ICU patients remains controversial [38].…”

Section: Discussionsupporting

confidence: 51%

“…These early periods of critical illness and inflammation are particularly significant in the development of muscle wasting and ICU-AW, as we [6, 14] and others [7] could recently show. Evoked muscle training to avoid immobilization due to EMS can be an option [10–12, 14], but application is labored, often not feasible [15], and in general EMS therapy for ICU patients remains controversial [38]. Alternatively WBV may be able to close the gap between immobilization and active physiotherapy, hypothesizing that frequently applied early muscle activation evoked by WBV may support patient recovery.…”

Section: Discussionsupporting

confidence: 51%

“…During this time course of disease there are further options for intensified passive mobilization by physiotherapists, such as passive cycling or motorized continuous passive motion for different conditions, which we separate from treatment options for active muscle training indicated by patients initiating muscle contraction or from external evoked ones. A series of investigations with electrical muscle stimulation (EMS) in critically ill patients therefore commenced, and while some EMS studies showed promising results [11, 14], others could not [13]. From our own experience we know that application of EMS is time consuming, if feasible at all, and effectiveness is inconsistent [15].…”

Section: Introductionmentioning

confidence: 99%

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Whole-body vibration to prevent intensive care unit-acquired weakness: safety, feasibility, and metabolic response

et al. 2017

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BackgroundIntensive care unit (ICU)-acquired weakness in critically ill patients is a common and significant complication affecting the course of critical illness. Whole-body vibration is known to be effective muscle training and may be an option in diminishing weakness and muscle wasting. Especially, patients who are immobilized and not available for active physiotherapy may benefit. Until now whole-body vibration was not investigated in mechanically ventilated ICU patients. We investigated the safety, feasibility, and metabolic response of whole-body vibration in critically ill patients.MethodsWe investigated 19 mechanically ventilated, immobilized ICU patients. Passive range of motion was performed prior to whole-body vibration therapy held in the supine position for 15 minutes. Continuous monitoring of vital signs, hemodynamics, and energy metabolism, as well as intermittent blood sampling, took place from the start of baseline measurements up to 1 hour post intervention. We performed comparative longitudinal analysis of the phases before, during, and after intervention.ResultsVital signs and hemodynamic parameters remained stable with only minor changes resulting from the intervention. No application had to be interrupted. We did not observe any adverse event. Whole-body vibration did not significantly and/or clinically change vital signs and hemodynamics. A significant increase in energy expenditure during whole-body vibration could be observed.ConclusionsIn our study the application of whole-body vibration was safe and feasible. The technique leads to increased energy expenditure. This may offer the chance to treat patients in the ICU with whole-body vibration. Further investigations should focus on the efficacy of whole-body vibration in the prevention of ICU-acquired weakness.Trial registrationApplicability and Safety of Vibration Therapy in Intensive Care Unit (ICU) Patients. ClinicalTrials.gov NCT01286610. Registered 28 January 2011.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1576-y) contains supplementary material, which is available to authorized users.

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“…Yet the definition of early mobilization is rather vague, as it encompasses a wide range of techniques practiced on different ICU populations [2, 3]. Nevertheless, early mobility interventions in critically ill patients prove to be feasible and safe in preventing bed-rest-associated morbidity [4–6], while improving patients’ physical function [7], psychological condition [8], and quality of life [9]. Mobilizing patients at an early time point has been associated with reduced health care costs [10], as such intervention decreases invasive mechanical ventilation (MV) duration, delirium [7, 11], and hospital length of stay [12].…”

Section: Introductionmentioning

confidence: 99%

Teamwork enables high level of early mobilization in critically ill patients

Hickmann

Castanares-Zapatero

Bialais

et al. 2016

Ann. Intensive Care

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BackgroundEarly mobilization in critically ill patients has been shown to prevent bed-rest-associated morbidity. Reported reasons for not mobilizing patients, thereby excluding or delaying such intervention, are diverse and comprise safety considerations for high-risk critically ill patients with multiple organ support systems. This study sought to demonstrate that early mobilization performed within the first 24 h of ICU admission proves to be feasible and well tolerated in the vast majority of critically ill patients.ResultsGeneral practice data were collected for 171 consecutive admissions to our ICU over a 2-month period according to a local, standardized, early mobilization protocol. The total period covered 731 patient-days, 22 (3 %) of which met our local exclusion criteria for mobilization. Of the remaining 709 patient-days, early mobilization was achieved on 86 % of them, bed-to-chair transfer on 74 %, and at least one physical therapy session on 59 %. Median time interval from ICU admission to the first early mobilization activity was 19 h (IQR = 15–23). In patients on mechanical ventilation (51 %), accounting for 46 % of patient-days, 35 % were administered vasopressors and 11 % continuous renal replacement therapy. Within this group, bed-to-chair transfer was achieved on 68 % of patient-days and at least one early mobilization activity on 80 %. Limiting factors to start early mobilization included restricted staffing capacities, diagnostic or surgical procedures, patients’ refusal, as well as severe hemodynamic instability. Hemodynamic parameters were rarely affected during mobilization, causing interruption in only 0.8 % of all activities, primarily due to reversible hypotension or arrhythmia. In general, all activities were well tolerated, while patients were able to self-regulate their active early mobilization. Patients’ subjective perception of physical therapy was reported to be enjoyable.ConclusionsMobilization within the first 24 h of ICU admission is achievable in the majority of critical ill patients, in spite of mechanical ventilation, vasopressor administration, or renal replacement therapy.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-016-0184-y) contains supplementary material, which is available to authorized users.

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Critical Illness Myopathy and GLUT4

Cited by 99 publications

References 43 publications

Glycated hemoglobin A1C and diabetes mellitus in critically ill patients

Glycated hemoglobin A1C and diabetes mellitus in critically ill patients

Whole-body vibration to prevent intensive care unit-acquired weakness: safety, feasibility, and metabolic response

Teamwork enables high level of early mobilization in critically ill patients

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