Muscle wasting and function after muscle activation and early protocol‐based physiotherapy: an explorative trial

Wollersheim, Tobias; Grunow, Julius J.; Carbon, Niklas M.; Haas, Kurt; Malleike, J.; Ramme, Sara F.; Schneider, Joanna; Spies, Claudia; Märdian, Sven; Mai, Knut; Spuler, Simone; Fielitz, Jens; Weber‐Carstens, Steffen

doi:10.1002/jcsm.12428

Cited by 62 publications

(89 citation statements)

References 32 publications

(65 reference statements)

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“…The findings may also suggest that muscle size may not be the best predictor of outcomes, specifically ICU-AW. Muscle mass or size has previously been shown not to correlate with muscle strength [ 69 , 70 ], potentially demonstrating that atrophy may not be the primary culprit of ICU-AW. These data, interpreted with caution, may support that deteriorations in muscle quality and muscle power may partially explain development of ICU-AW.…”

Section: Discussionmentioning

confidence: 99%

Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness

et al. 2020

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Background Patients surviving critical illness develop muscle weakness and impairments in physical function; however, the relationship between early skeletal muscle alterations and physical function at hospital discharge remains unclear. The primary purpose of this study was to determine whether changes in muscle size, strength and power assessed in the intensive care unit (ICU) predict physical function at hospital discharge. Methods Study design is a single-center, prospective, observational study in patients admitted to the medicine or cardiothoracic ICU with diagnosis of sepsis or acute respiratory failure. Rectus femoris (RF) and tibialis anterior (TA) muscle ultrasound images were obtained day one of ICU admission, repeated serially and assessed for muscle cross-sectional area (CSA), layer thickness (mT) and echointensity (EI). Muscle strength, as measured by Medical Research Council-sum score, and muscle power (lower-extremity leg press) were assessed prior to ICU discharge. Physical function was assessed with performance on 5-times sit-to-stand (5STS) at hospital discharge. Results Forty-one patients with median age of 61 years (IQR 55–68), 56% male and sequential organ failure assessment score of 8.1 ± 4.8 were enrolled. RF muscle CSA decreased significantly a median percent change of 18.5% from day 1 to 7 (F = 26.6, p = 0.0253). RF EI increased at a mean percent change of 10.5 ± 21% in the first 7 days (F = 3.28, p = 0.081). At hospital discharge 25.7% of patients (9/35) met criteria for ICU-acquired weakness. Change in RF EI in first 7 days of ICU admission and muscle power measured prior to ICU were strong predictors of ICU-AW at hospital discharge (AUC = 0.912). Muscle power at ICU discharge, age and ICU length of stay were predictive of performance on 5STS at hospital discharge. Conclusion ICU-assessed muscle alterations, specifically RF EI and muscle power, are predictors of diagnosis of ICU-AW and physical function assessed by 5x-STS at hospital discharge in patients surviving critical illness.

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Section: Discussionmentioning

confidence: 99%

Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness

et al. 2020

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“…74 Neuromuscular electrical stimulation has been shown to prevent muscle atrophy via induction of protein synthesis, although a clinical outcome benefit has not yet been unequivocally established. 75,76 A differing contractile response to neuromuscular electrical stimulation has been hypothesized as a reason for that lack of clinical effectiveness, and future research into different protocols, as well as the underlying mechanisms, behind the postulated differing contractile response is still warranted. Functional electrical stimulation combines neuromuscular electrical stimulation and in-bed cycling, thus coupling the muscle stimulation with the corresponding movements.…”

Section: Active Mobilization In Unconscious Patientsmentioning

confidence: 99%

Innovative ICU Solutions to Prevent and Reduce Delirium and Post–Intensive Care Unit Syndrome

Luetz

Grunow

Mörgeli

et al. 2019

Semin Respir Crit Care Med

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Delirium, the most common form of acute brain dysfunction affecting up to 80% of intensive care unit (ICU) patients, has been shown to predict long-term cognitive impairment, one of the domains in “Post-ICU Syndrome” (PICS). The ICU environment affects several potentially modifiable risk factors for delirium, such as disorientation and disruption, of the sleep–wake cycle. Innovative solutions aim to transform standard concepts of ICU room design to limit potential stressors, and utilizing the patient care space as a treatment tool, exerting positive, therapeutic effects. The main areas affected by most architectural and interior design modifications are sound environment, light control, floor planning, and room arrangement. Implementation of corresponding solutions is challenging considering the significant medical and technical demands of ICUs. This article discusses innovative concepts and promising approaches in ICU design that may be used to prevent stress and to support the healing process of patients, potentially limiting the impact of delirium and PICS.

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“…The myocyte cross-sectional area of the intervention group was significantly higher (type I + 36%, type IIa + 49%, type IIb + 65%, p < 0.001 for all) compared to the control group (type I + 10%, type IIa + 13%, type IIb + 3%, p < 0.001 for all). This increase was accompanied by regulated gene expression for myosin heavy chains (fold change median [IQR]: MYH1 2.3 [1.1 -2.7], MYH2 0.7 [0.2 -1.8]; MYH4 5.1 [2.2 -15.3]) indicating that the muscle protein synthesis pathway was activated, probably due induced by muscle activation [16].…”

Section: Parameters Of Nmes and Local Effectsmentioning

confidence: 99%

“…Since a large proportion of critical patients cannot participate in any active mobilization, neuromuscular electrical stimulation (NMES) may be an alternative strategy for muscle training [13]. NMES has been used in protocols of early mobilization in ICU with the objective of reversing muscle weakness, preserving muscle mass and preventing atrophy, preserving function and reducing complications and disability [13] [14] [15] [16]. In addition, studies have shown that its application is safe and viable [17] [18] [19].…”

Section: Introductionmentioning

confidence: 99%

Neuromuscular Electrical Stimulation in Intensive Care Unit Patients: Integrative Review

Baron¹,

Pinto²,

Koepp³

et al. 2019

MRI

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Intensive care units' acquired muscle weakness is present in approximately 50% of the patients. Although active muscle training can attenuate weakness, a large proportion of critical patients cannot participate in any active mobilization. Neuromuscular electrical stimulation may be an alternative strategy to reverse muscle weakness. The objective of the study was to review the scientific publications on the use of neuromuscular electrical stimulation and its parameters and the main results in patients hospitalized in intensive care units. This is an integrative review surveying studies in online databases. The studies were selected from the following descriptors: neuromuscular electrical stimulation AND parameters AND intensive care units AND muscle weakness. The inclusion criteria included articles that addressed the topic of neuromuscular electrical stimulation and the parameters used in patients admitted to intensive care units, aged 18 years or older. Exclusion criteria were studies involving animals, case reports, letters to the editor and book chapters. The search comprised articles in the Portuguese, English and Spanish languages from

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Muscle wasting and function after muscle activation and early protocol‐based physiotherapy: an explorative trial

Cited by 62 publications

References 32 publications

Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness

Acute skeletal muscle wasting and dysfunction predict physical disability at hospital discharge in patients with critical illness

Innovative ICU Solutions to Prevent and Reduce Delirium and Post–Intensive Care Unit Syndrome

Neuromuscular Electrical Stimulation in Intensive Care Unit Patients: Integrative Review

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