2017
DOI: 10.1097/mcc.0000000000000431
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Muscle mass and physical recovery in ICU: innovations for targeting of nutrition and exercise

Abstract: Purpose of Review We have significantly improved hospital mortality from sepsis and critical illness in last 10 years, however over this same period we have tripled the number of “ICU survivors” going to rehabilitation. Further, as up to half the deaths in the first year following ICU admission occur post-ICU discharge, it is unclear how many of these patients ever returned home or a meaningful quality of life (QoL). For those who do survive, recent data reveals many “ICU survivors” will suffer significant fun… Show more

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Cited by 50 publications
(17 citation statements)
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“…Sepsis, difficult ventilator liberation, and prolonged mechanical ventilation are among the well-known risk factors associated with neuromuscular acquired weakness [26]. Aggressive nutritional therapy and early exercise should be considered to prevent muscle wasting or to maintain muscle, although they may fail when applied early in critically ill patients [2,3]. However, BMI assessment does not indicate the muscle quality and quantity of wasting in these patients.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Sepsis, difficult ventilator liberation, and prolonged mechanical ventilation are among the well-known risk factors associated with neuromuscular acquired weakness [26]. Aggressive nutritional therapy and early exercise should be considered to prevent muscle wasting or to maintain muscle, although they may fail when applied early in critically ill patients [2,3]. However, BMI assessment does not indicate the muscle quality and quantity of wasting in these patients.…”
Section: Discussionmentioning
confidence: 99%
“…Moreover, increased energy and protein administration within the first acute-phase admission week does not seem to prevent muscle wasting or promote muscle preservation. Protein-loading and exercise, although used successfully to treat frailty in older patients [1], may fail in the still not well-defined group of severely catabolic patients, if applied as a standard treatment [2,3].…”
Section: Introductionmentioning
confidence: 99%
“…But, as always, this increase in calorie delivery should be targeted with objective data when possible via use of improved metabolic cart technology. In the future, great promise seems to exist for bedside 13 C/ 12 C breath carbon ratio mass spectroscopy [ 46 , 47 ] to assist in direct objective measurement of overfeeding and underfeeding. Finally, we must learn to target and incorporate nutritional therapies such as vitamin D, probiotics, and anabolic/anti-catabolic agents to optimize our patients’ chance to survive and thrive against all evolutionary odds.…”
Section: Discussionmentioning
confidence: 99%
“…Concerns regarding PN are the potential risk of overfeeding with hyperglycemia, elevated liver enzymes and increased rate of blood stream infections. Current evidence remains inconclusive, but there seems to be no difference regarding clinical outcome between EN and PN [ 91 , 92 , 93 ]. However, in the EPaNIC Trial of Casaer et al, a lower rate of infection was observed with a later achievement of caloric targets [ 94 ].…”
Section: Perioperative Nutrition Support In Cardiac Surgery Patienmentioning
confidence: 99%