Muscle Protein Synthesis after Protein Administration in Critical Illness

Chapple, Lee‐anne S.; Kouw, Imre W. K.; Summers, Matthew J.; Weinel, Luke M; Gluck, Samuel; Raith, Eamon; Slobodian, Peter; Soenen, Stijn; Deane, Adam M.; Loon, Luc J.C. van; Chapman, Marianne J.

doi:10.1164/rccm.202112-2780oc

Cited by 48 publications

(49 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Muscle protein synthesis following protein administration is blunted in critical illness [67]. However, indirect evidence, using nitrogen balance determinations, indicates that this anabolic resistance can be mediated by increasing protein intake in critically ill trauma patients with or without obesity [26,27,68].…”

Section: Current Guidelines For Protein Provisionmentioning

confidence: 99%

Obesity and critical care nutrition: current practice gaps and directions for future research

Dickerson

Andromalos²,

Brown

et al. 2022

Crit Care

View full text Add to dashboard Cite

Background This review has been developed following a panel discussion with an international group of experts in the care of patients with obesity in the critical care setting and focuses on current best practices in malnutrition screening and assessment, estimation of energy needs for patients with obesity, the risks and management of sarcopenic obesity, the value of tailored nutrition recommendations, and the emerging role of immunonutrition. Patients admitted to the intensive care unit (ICU) increasingly present with overweight and obesity that require individualized nutrition considerations due to underlying comorbidities, immunological factors such as inflammation, and changes in energy expenditure and other aspects of metabolism. While research continues to accumulate, important knowledge gaps persist in recognizing and managing the complex nutritional needs in ICU patients with obesity. Available malnutrition screening and assessment tools are limited in patients with obesity due to a lack of validation and heterogeneous factors impacting nutrition status in this population. Estimations of energy and protein demands are also complex in patients with obesity and may include estimations based upon ideal, actual, or adjusted body weight. Evidence is still sparse on the role of immunonutrition in patients with obesity, but the presence of inflammation that impacts immune function may suggest a role for these nutrients in hemodynamically stable ICU patients. Educational efforts are needed for all clinicians who care for complex cases of critically ill patients with obesity, with a focus on strategies for optimal nutrition and the consideration of issues such as weight stigma and bias impacting the delivery of care. Conclusions Current nutritional strategies for these patients should be undertaken with a focus on individualized care that considers the whole person, including the possibility of preexisting comorbidities, altered metabolism, and chronic stigma, which may impact the provision of nutritional care. Additional research should focus on the applicability of current guidelines and evidence for nutrition therapy in populations with obesity, especially in the setting of critical illness.

show abstract

Section: Current Guidelines For Protein Provisionmentioning

confidence: 99%

Obesity and critical care nutrition: current practice gaps and directions for future research

Dickerson

Andromalos²,

Brown

et al. 2022

Crit Care

View full text Add to dashboard Cite

show abstract

“…Indeed, no clear evidence supports amino acid supplements [91], and a post hoc analysis of EPaNIC (Early Parenteral Nutrition to Supplement Insufficient Enteral Nutrition in Intensive Care trial) confirmed a higher incidence of ICUAW in early parenteral nutrition patients [92]. These findings suggest that the early catabolic phase during critical illness cannot be averted by artificial nutrition, as critically ill patients are not able to use the exogenous amino acids for muscle protein synthesis [93 ▪▪ ].…”

Section: Icu-acquired Weaknessmentioning

confidence: 99%

Neurological complications of sepsis

Piva

Bertoni

Gitti

et al. 2023

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of reviewSepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, is a leading cause of hospital and ICU admission. The central and peripheral nervous system may be the first organ system to show signs of dysfunction, leading to clinical manifestations such as sepsis-associated encephalopathy (SAE) with delirium or coma and ICU-acquired weakness (ICUAW). In the current review, we want to highlight developing insights into the epidemiology, diagnosis, prognosis, and treatment of patients with SAE and ICUAW.Recent findingsThe diagnosis of neurological complications of sepsis remains clinical, although the use of electroencephalography and electromyography can support the diagnosis, especially in noncollaborative patients, and can help in defining disease severity. Moreover, recent studies suggest new insights into the long-term effects associated with SAE and ICUAW, highlighting the need for effective prevention and treatment.SummaryIn this manuscript, we provide an overview of recent insights and developments in the prevention, diagnosis, and treatment of patients with SAE and ICUAW.

show abstract

“…Contemporary stable isotope methodology assessing whole-body and muscle protein anabolic response to protein delivery has only been addressed by a few studies [11], as this technique is expensive, labour-intensive, and requires repeated blood sampling and skeletal muscle tissue collection [12]. Chapple et al [10 ▪ ] quantified postprandial protein handling in response to duodenal protein feeding in ICU patients and BMI and age-matched healthy control subjects. Although dietary amino acid uptake was similar between groups, the deposition of dietary amino acids into myofibrillar protein was 60% lower after the protein bolus.…”

Section: Protein Provisionmentioning

confidence: 99%

Current insights in ICU nutrition: tailored nutrition

Hermans

Laarhuis²,

Kouw

et al. 2023

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of reviewTo summarize recent research on critical care nutrition focusing on the optimal composition, timing, and monitoring of enteral feeding strategies for (post)-ICU patients. We provide new insights on energy and protein recommendations, feeding intolerance, and describe nutritional practices for coronavirus disease 2019 ICU patients.Recent findingsThe use of indirect calorimetry to establish individual energy requirements for ICU patients is considered the gold standard. The limited research on optimal feeding targets in the early phase of critical illness suggests avoiding overfeeding. Protein provision based upon the absolute lean body mass is rational. Therefore, body composition measurements should be considered. Body impedance analysis and muscle ultrasound seem reliable, affordable, and accessible methods to assess body composition at the bedside. There is inadequate evidence to change our practice of continuous enteral feeding into intermittent feeding. Finally, severe acute respiratory syndrome coronavirus 2 patients are prone to underfeeding due to hypermetabolism and should be closely monitored.SummaryNutritional therapy should be adapted to the patient's characteristics, diagnosis, and state of metabolism during ICU stay and convalescence. A personalized nutrition plan may prevent harmful over- or underfeeding and attenuate muscle loss. Despite novel insights, more research is warranted into tailored nutrition strategies during critical illness and convalescence.

show abstract

Muscle Protein Synthesis after Protein Administration in Critical Illness

Cited by 48 publications

References 44 publications

Obesity and critical care nutrition: current practice gaps and directions for future research

Obesity and critical care nutrition: current practice gaps and directions for future research

Neurological complications of sepsis

Current insights in ICU nutrition: tailored nutrition

Contact Info

Product

Resources

About