Top

Current Osteoporosis Reports

Published in:

Open Access 31-08-2022 | Nutrition | Nutrition, Exercise and Lifestyle (S Shapses and R Daly, Section Editors)

Attenuating Muscle Mass Loss in Critical Illness: the Role of Nutrition and Exercise

Authors: Lee-anne S. Chapple, Selina M. Parry, Stefan J. Schaller

Published in: Current Osteoporosis Reports | Issue 5/2022

Abstract

Purpose of Review

Impaired recovery following an intensive care unit (ICU) admission is thought related to muscle wasting. Nutrition and physical activity are considered potential avenues to attenuate muscle wasting. The aim of this review was to present evidence for these interventions in attenuating muscle loss or improving strength and function.

Recent Findings

Randomised controlled trials on the impact of nutrition or physical activity interventions in critically ill adult patients on muscle mass, strength or function are presented. No nutrition intervention has shown an effect on strength or function, and the effect on muscle mass is conflicting. RCTs on the effect of physical activity demonstrate conflicting results; yet, there is a signal for improved strength and function with higher levels of physical activity, particularly when commenced early.

Summary

Further research is needed to elucidate the impact of nutrition and physical activity on muscle mass, strength and function, particularly in combination.

Moisey LL, Mourtzakis M, Cotton BA, Premji T, Heyland DK, Wade CE, et al. Skeletal muscle predicts ventilator-free days, ICU-free days, and mortality in elderly ICU patients. Critical Care (London, England). 2013;17(5):R206.CrossRef

2.••

Puthucheary ZA, Rawal J, McPhail M, Connolly B, Ratnayake G, Chan P, et al. Acute skeletal muscle wasting in critical illness. JAMA. 2013;310(15):1591–600 Landmark paper which identified acute muscle wasting occurs early and rapidly in critical illness.PubMedCrossRef

Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348:683–93.PubMedCrossRef

4.•

Deane AM, Little L, Bellomo R, Chapman MJ, Davies AR, Ferrie S, et al. Outcomes six months after delivering 100% or 70% of enteral calorie requirements during critical illness (TARGET). A randomized controlled trial. Am J Respir Crit Care Med. 2020;201(7):814–22 Outcome data from critically ill patients randomised to receive augmented enteral calories compared to standard care demonstrated no impact of calorie delivery on quality of life or functional outcomes.PubMedCrossRef

5.•

Parry SM, Nalamalapu SR, Nunna K, Rabiee A, Friedman LA, Colantuoni E, et al. Six-minute walk distance after critical illness: a systematic review and meta-analysis. J Intensive Care Med. 2021;36(3):343–51 Systematic review synthesising physical functioning data measured using 6-minute walk distance with identified risk factors for poor physical functioning recovery which may be relevant to the design of clinical studies.PubMedCrossRef

Batt J, Herridge MS, Dos Santos CC. From skeletal muscle weakness to functional outcomes following critical illness: a translational biology perspective. Thorax. 2019;74(11):1091–8.PubMedCrossRef

Parry SM, Puthucheary ZA. The impact of extended bed rest on the musculoskeletal system in the critical care environment. Extrem Physiol Med. 2015;4:16.PubMedPubMedCentralCrossRef

8.•

Liebau F, Deane AM, Rooyackers O. Protein absorption and kinetics in critical illness. Curr Opin Clin Nutr Metab Care. 2021;24(1):71–8 A broad review on impairments in protein metabolism in critically ill patients.PubMedCrossRef

Bear DE, Parry SM, Puthucheary ZA. Can the critically ill patient generate sufficient energy to facilitate exercise in the ICU? Curr Opin Clin Nutr Metab Care. 2018;21(2):110–5.PubMedCrossRef

10.

•• Chapple LS, Kouw IWK, Summers MJ, Weinel LM, Gluck S, Raith E, et al. Muscle protein synthesis following protein administration in critical illness. Am J Respir Crit Care Med. 2022. https://doi.org/10.1164/rccm.202112-2780OCUsing comprehensive tracer methodology, this study reported skeletal muscle protein synthesis following intraduodenally delivered dietary protein is impaired in critical illness, despite near normal protein digestion and amino acid absorption.

11.

Hayashida I, Tanimoto Y, Takahashi Y, Kusabiraki T, Tamaki J. Correlation between muscle strength and muscle mass, and their association with walking speed, in community-dwelling elderly Japanese individuals. PLoS One. 2014;9(11):e111810.PubMedPubMedCentralCrossRef

12.

Looijaard W, Molinger J, Weijs PJM. Measuring and monitoring lean body mass in critical illness. Curr Opin Crit Care. 2018;24(4):241–7.PubMedPubMedCentralCrossRef

13.

Ismael S, Savalle M, Trivin C, Gillaizeau F, D'Auzac C, Faisy C. The consequences of sudden fluid shifts on body composition in critically ill patients. Crit Care. 2014;18(2):R49.PubMedPubMedCentralCrossRef

14.

Looijaard WG, Dekker IM, Stapel SN, Girbes AR, Twisk JW, Oudemans-van Straaten HM, et al. Skeletal muscle quality as assessed by CT-derived skeletal muscle density is associated with 6-month mortality in mechanically ventilated critically ill patients. Crit Care. 2016;20(1):386.PubMedPubMedCentralCrossRef

15.

Mourtzakis M, Parry S, Connolly B, Puthucheary Z. Skeletal muscle ultrasound in critical care: a tool in need of translation. Ann Am Thorac Soc. 2017;14(10):1495–503.PubMedPubMedCentralCrossRef

16.

Klawitter F, Walter U, Patejdl R, Endler J, Reuter DA, Ehler J. Sonographic evaluation of muscle echogenicity for the detection of intensive care unit-acquired weakness: a pilot single-center prospective cohort study. Diagnostics (Basel). 2022;12(6):1378.PubMedCentralCrossRef

17.

Baldwin CE, Fetterplace K, Beach L, Kayambu G, Paratz J, Earthman C, et al. Early Detection of muscle weakness and functional limitations in the critically ill: a retrospective evaluation of bioimpedance spectroscopy. JPEN J Parenter Enteral Nutr. 2019.

18.

Holecek M, Vodenicarovova M. Effects of beta-hydroxy-beta-methylbutyrate supplementation on skeletal muscle in healthy and cirrhotic rats. Int J Exp Pathol. 2019;100(3):175–83.PubMedPubMedCentralCrossRef

19.

Cuthbertson D, Smith K, Babraj J, Leese G, Waddell T, Atherton P, et al. Anabolic signaling deficits underlie amino acid resistance of wasting, aging muscle. FASEB J. 2005;19(3):422–4.PubMedCrossRef

20.

Oikawa SY, Holloway TM, Phillips SM. The impact of step reduction on muscle health in aging: protein and exercise as countermeasures. Front Nutr. 2019;6:75.PubMedPubMedCentralCrossRef

21.

Nishiguchi S, Yamada M, Kajiwara Y, Sonoda T, Yoshimura K, Kayama H, et al. Effect of physical activity at midlife on skeletal muscle mass in old age in community-dwelling older women: a cross-sectional study. J Clin Gerontol Geriatr. 2014;5(1):18–22.CrossRef

22.

Dempsey PC, Friedenreich CM, Leitzmann MF, Buman MP, Lambert E, Willumsen J, et al. Global public health guidelines on physical activity and sedentary behavior for people living with chronic conditions: a call to action. J Phys Act Health. 2021;18(1):76–85.PubMedCrossRef

23.

Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59.PubMedCrossRef

24.

Biolo G, Maggi SP, Williams BD, Tipton KD, Wolfe RR. Increased rates of muscle protein turnover and amino acid transport after resistance exercise in humans. Am J Phys. 1995;268(3 Pt 1):E514–20.

25.

Pennings B, Koopman R, Beelen M, Senden JM, Saris WH, van Loon LJ. Exercising before protein intake allows for greater use of dietary protein-derived amino acids for de novo muscle protein synthesis in both young and elderly men. Am J Clin Nutr. 2011;93(2):322–31.PubMedCrossRef

26.••

Devlin JW, Skrobik Y, Gelinas C, Needham DM, Slooter AJC, Pandharipande PP, et al. Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU. Crit Care Med. 2018;46(9):e825–e73 International Clinical Practice Guidelines with the inclusion of a section on mobilisation and rehabilitation.PubMedCrossRef

27.

Lang JK, Paykel MS, Haines KJ, Hodgson CL. Clinical practice guidelines for early mobilization in the ICU: a systematic review. Crit Care Med. 2020;48(11):e1121–e8.PubMedCrossRef

28.

McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40(2):159–211.PubMedCrossRef

29.

Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48–79.PubMedCrossRef

30.••

Compher C, Bingham AL, McCall M, Patel J, Rice TW, Braunschweig C, et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2022;46(1):12–41 An ASPEN guideline update for nutrition management of critically ill patients, which includes an appraisal of evidence on protein dose and outcomes.PubMedCrossRef

31.

Chapple LS, Ridley EJ, Chapman MJ. Trial design in critical care nutrition: the past, present and future. Nutrients. 2020;12(12):3694.PubMedCentralCrossRef

32.•

Reintam Blaser A, Preiser JC, Fruhwald S, Wilmer A, Wernerman J, Benstoem C, et al. Gastrointestinal dysfunction in the critically ill: a systematic scoping review and research agenda proposed by the Section of Metabolism, Endocrinology and Nutrition of the European Society of Intensive Care Medicine. Crit Care. 2020;24(1):224 A comprehensive review of GI dysfunction in critical illness spanning monitoring, relationships between GI function and nutrition and outcomes, and management of GI dysfunction.PubMedPubMedCentralCrossRef

33.

Carbon NM, Engelhardt LJ, Wollersheim T, Grunow JJ, Spies CD, Mardian S, et al. Impact of protocol-based physiotherapy on insulin sensitivity and peripheral glucose metabolism in critically ill patients. J Cachexia Sarcopenia Muscle. 2022;13(2):1045–53.PubMedPubMedCentralCrossRef

34.

Caspersen C. Physical activity, exercise and physical fitness: definitions and distinctions for health related research. Public Health Rep. 1985;100(2):126–31.PubMedPubMedCentral

35.

Piercy KL, Troiano RP, Ballard RM, Carlson SA, Fulton JE, Galuska DA, et al. The physical activity guidelines for Americans. JAMA. 2018;320(19):2020–8.PubMedCrossRef

36.

Sparling PB, Howard BJ, Dunstan DW, Owen N. Recommendations for physical activity in older adults. BMJ. 2015;350:h100.PubMedCrossRef

37.

Parry SM, Knight LD, Connolly B, Baldwin C, Puthucheary Z, Morris P, et al. Factors influencing physical activity and rehabilitation in survivors of critical illness: a systematic review of quantitative and qualitative studies. Intensive Care Med. 2017;43(4):531–42.PubMedCrossRef

38.

Hermes C, Nydahl P, Blobner M, Dubb R, Filipovic S, Kaltwasser A, et al. Assessment of mobilization capacity in 10 different ICU scenarios by different professions. PLoS One. 2020;15(10):e0239853.PubMedPubMedCentralCrossRef

39.

Beach LJ, Fetterplace K, Edbrooke L, Parry SM, Curtis R, Rechnitzer T, et al. Measurement of physical activity levels in the intensive care unit and functional outcomes: an observational study. J Crit Care. 2017;40:189–96.PubMedCrossRef

40.•

Black C, Grocott M, Singer M. The oxygen cost of rehabilitation interventions in mechanically ventilated patients: an observational study. Physiotherapy. 2020;107:169–75 This study provides important data on the oxygen cost associated with rehabilitation interventions in the ICU population.PubMedCrossRef

41.

Allingstrup MJ, Kondrup J, Wiis J, Claudius C, Pedersen UG, Hein-Rasmussen R, et al. Early goal-directed nutrition versus standard of care in adult intensive care patients: the single-centre, randomised, outcome assessor-blinded EAT-ICU trial. Intensive Care Med. 2017;43(11):1637–47.PubMedCrossRef

42.

Casaer MP, Mesotten D, Hermans G, Wouters PJ, Schetz M, Meyfroidt G, et al. Early versus late parenteral nutrition in critically ill adults. N Engl J Med. 2011;365(6):506–17.PubMedCrossRef

43.

Doig GS, Simpson F, Sweetman EA, Finfer SR, Cooper DJ, Heighes PT, et al. Early parenteral nutrition in critically ill patients with short-term relative contraindications to early enteral nutrition: a randomized controlled trial. JAMA. 2013;309(20):2130–8.PubMedCrossRef

44.

Doig GS, Simpson F, Bellomo R, Heighes PT, Sweetman EA, Chesher D, et al. Intravenous amino acid therapy for kidney function in critically ill patients: a randomized controlled trial. Intensive Care Med. 2015;41(7):1197–208.PubMedCrossRef

45.•

Dresen E, Weissbrich C, Fimmers R, Putensen C, Stehle P. Medical high-protein nutrition therapy and loss of muscle mass in adult ICU patients: a randomized controlled trial. Clin Nutr. 2021;40(4):1562–70 The delivery of 1.2 g protein/kg/day versus 1.8 g protein/kg/day in critically ill patients had no impact on ultrasound-derived muscle loss.PubMedCrossRef

46.

Ferrie S, Allman-Farinelli M, Daley M, Smith K. Protein requirements in the critically ill: a randomized controlled trial using parenteral nutrition. JPEN. J Parenter Enter Nutr. 2016;40(6):795–805.CrossRef

47.

Fetterplace K, Deane AM, Tierney A, Beach LJ, Knight LD, Presneill J, et al. Targeted full energy and protein delivery in critically ill patients: a pilot randomized controlled trial (FEED Trial). JPEN: J Parenter Enteral Nutr. 2018.

48.•

McNelly AS, Bear DE, Connolly BA, Arbane G, Allum L, Tarbhai A, et al. Effect of intermittent or continuous feed on muscle wasting in critical illness: a phase 2 clinical trial. Chest. 2020;158(1):183–94 An RCT on the effect of intermittent versus continuous enteral nutrition administration in critically ill patients in which greater protein dose was received in the intermittent feeding arm, with no differences in ultrasound-derived muscle size between groups.PubMedCrossRef

49.•

Nakamura K, Kihata A, Naraba H, Kanda N, Takahashi Y, Sonoo T, et al. beta-Hydroxy-beta-methylbutyrate, arginine, and glutamine complex on muscle volume loss in critically ill patients: a randomized control trial. JPEN J Parenter Enteral Nutr. 2020;44(2):205–12 An RCT in critically ill patients reported no difference in muscle mass using computed tomography of the femoral muscle when comparing HMB with placebo.PubMedCrossRef

50.

Ridley EJ, Davies AR, Parke R, Bailey M, McArthur C, Gillanders L, et al. Supplemental parenteral nutrition versus usual care in critically ill adults: a pilot randomized controlled study. Crit Care. 2018;22(1):12.PubMedPubMedCentralCrossRef

51.•

Viana MV, Becce F, Pantet O, Schmidt S, Bagnoud G, Thaden JJ, et al. Impact of beta-hydroxy-beta-methylbutyrate (HMB) on muscle loss and protein metabolism in critically ill patients: a RCT. Clin Nutr. 2021;40(8):4878–87 A second RCT that also reported no effect of HMB on muscle loss in critically ill patients.PubMedCrossRef

52.

Wischmeyer PE, Hasselmann M, Kummerlen C, Kozar R, Kutsogiannis DJ, Karvellas CJ, et al. A randomized trial of supplemental parenteral nutrition in underweight and overweight critically ill patients: the TOP-UP pilot trial. Crit Care. 2017;21(1):142.PubMedPubMedCentralCrossRef

53.

Gamrin-Gripenberg L, Sundstrom-Rehal M, Olsson D, Grip J, Wernerman J, Rooyackers O. An attenuated rate of leg muscle protein depletion and leg free amino acid efflux over time is seen in ICU long-stayers. Crit Care. 2018;22(1):13.PubMedPubMedCentralCrossRef

54.••

Wang YT, Lang JK, Haines KJ, Skinner EH, Haines TP. Physical rehabilitation in the ICU: a systematic review and meta-analysis. Crit Care Med. 2022;50(3):375–88 A detailed systematic review synthesising the current evidence on physical rehabilitation in the ICU.PubMed

55.

Tipping CJ, Harrold M, Holland A, Romero L, Nisbet T, Hodgson CL. The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive Care Med. 2017;43(2):171–83.PubMedCrossRef

56.

Waldauf P, Jiroutkova K, Krajcova A, Puthucheary Z, Duska F. Effects of rehabilitation interventions on clinical outcomes in critically ill patients: systematic review and meta-analysis of randomized controlled trials. Crit Care Med. 2020;48(7):1055–65.PubMed

57.

Berney S, Hopkins RO, Rose JW, Koopman R, Puthucheary Z, Pastva A, et al. Functional electrical stimulation in-bed cycle ergometry in mechanically ventilated patients: a multicentre randomised controlled trial. Thorax. 2021;76(7):656–63.PubMedCrossRef

58.••

Burtin C, Clerckx B, Robbeets C, Ferdinande P, Langer D, Troosters T, et al. Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med. 2009;37(9):2499–505 Outstanding trial which was the first to demonstrate the efficacy of cycle ergometry in the ICU population on short-term benefits (up to hospital discharge).PubMedCrossRef

59.

Eggmann S, Verra ML, Luder G, Takala J, Jakob SM. Effects of early, combined endurance and resistance training in mechanically ventilated, critically ill patients: a randomised controlled trial. PLoS One. 2018;13(11):e0207428.PubMedPubMedCentralCrossRef

60.

Fossat G, Baudin F, Courtes L, Bobet S, Dupont A, Bretagnol A, et al. Effect of in-bed leg cycling and electrical stimulation of the quadriceps on global muscle strength in critically ill adults: a randomized clinical trial. JAMA. 2018;320(4):368–78.PubMedPubMedCentralCrossRef

61.

Gama Lordello GG, Goncalves Gama GG, Lago Rosier G, Viana P, Correia LC, Fonteles Ritt LE. Effects of cycle ergometer use in early mobilization following cardiac surgery: a randomized controlled trial. Clin Rehabil. 2020;34(4):450–9.PubMedCrossRef

62.

Kho ME, Molloy AJ, Clarke FJ, Reid JC, Herridge MS, Karachi T, et al. Multicentre pilot randomised clinical trial of early in-bed cycle ergometry with ventilated patients. BMJ Open Respir Res. 2019;6(1):e000383.PubMedPubMedCentralCrossRef

63.

Machado ADS, Pires-Neto RC, Carvalho MTX, Soares JC, Cardoso DM, Albuquerque IM. Effects that passive cycling exercise have on muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients: a randomized clinical trial. J Bras Pneumol. 2017;43(2):134–9.PubMedPubMedCentralCrossRef

64.

Nickels MR, Aitken LM, Barnett AG, Walsham J, King S, Gale NE, et al. Effect of in-bed cycling on acute muscle wasting in critically ill adults: a randomised clinical trial. J Crit Care. 2020;59:86–93.PubMedCrossRef

65.

Cui Z, Li N, Gao C, Fan Y, Zhuang X, Liu J, et al. Precision implementation of early ambulation in elderly patients undergoing off-pump coronary artery bypass graft surgery: a randomized-controlled clinical trial. BMC Geriatr. 2020;20(1):404.PubMedPubMedCentralCrossRef

66.

Dantas CM, Silva PF, Siqueira FH, Pinto RM, Matias S, Maciel C, et al. Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. Rev Bras Ter Intensiva. 2012;24(2):173–8.PubMedCrossRef

67.

Denehy L, Skinner EH, Edbrooke L, Haines K, Warrillow S, Hawthorne G, et al. Exercise rehabilitation for patients with critical illness: a randomized controlled trial with 12 months of follow-up. Crit Care. 2013;17(4):R156.PubMedPubMedCentralCrossRef

68.

Dong ZH, Yu BX, Sun YB, Fang W, Li L. Effects of early rehabilitation therapy on patients with mechanical ventilation. World J Emerg Med. 2014;5(1):48–52.PubMedPubMedCentralCrossRef

69.

Hickmann CE, Castanares-Zapatero D, Deldicque L, Van den Bergh P, Caty G, Robert A, et al. Impact of very early physical therapy during septic shock on skeletal muscle: a randomized controlled trial. Crit Care Med. 2018;46(9):1436–43.PubMedPubMedCentralCrossRef

70.

Hodgson CL, Bailey M, Bellomo R, Berney S, Buhr H, Denehy L, et al. A binational multicenter pilot feasibility randomized controlled trial of early goal-directed mobilization in the ICU. Crit Care Med. 2016;44(6):1145–52.PubMedCrossRef

71.

ECMO-PT Study Investigators and International ECMO Network. Early mobilisation during extracorporeal membrane oxygenation was safe and feasible: a pilot randomised controlled trial. Intensive Care Med. 2020;46(5):1057–9.CrossRef

72.

Kayambu G, Boots R, Paratz J. Early physical rehabilitation in intensive care patients with sepsis syndromes: a pilot randomised controlled trial. Intensive Care Med. 2015;41(5):865–74.PubMedCrossRef

73.

Maffei P, Wiramus S, Bensoussan L, Bienvenu L, Haddad E, Morange S, et al. Intensive early rehabilitation in the intensive care unit for liver transplant recipients: a randomized controlled trial. Arch Phys Med Rehabil. 2017;98(8):1518–25.PubMedCrossRef

74.

McWilliams D, Jones C, Atkins G, Hodson J, Whitehouse T, Veenith T, et al. Earlier and enhanced rehabilitation of mechanically ventilated patients in critical care: a feasibility randomised controlled trial. J Crit Care. 2018;44:407–12.PubMedCrossRef

75.

Morris PE, Berry MJ, Files DC, Thompson JC, Hauser J, Flores L, et al. Standardized rehabilitation and hospital length of stay among patients with acute respiratory failure: a randomized clinical trial. JAMA. 2016;315(24):2694–702.PubMedPubMedCentralCrossRef

76.

Moss M, Nordon-Craft A, Malone D, Van Pelt D, Frankel SK, Warner ML, et al. A randomized trial of an intensive physical therapy program for patients with acute respiratory failure. Am J Respir Crit Care Med. 2016;193(10):1101–10.PubMedPubMedCentralCrossRef

77.

Nava S. Rehabilitation of patients admitted to a respiratory intensive care unit. Arch Phys Med Rehabil. 1998;79(7):849–54.PubMedCrossRef

78.

Nydahl P, Gunther U, Diers A, Hesse S, Kerschensteiner C, Klarmann S, et al. PROtocol-based MObilizaTION on intensive care units: stepped-wedge, cluster-randomized pilot study (Pro-Motion). Nurs Crit Care. 2020;25(6):368–75.PubMedCrossRef

79.••

Schaller SJ, Anstey M, Blobner M, Edrich T, Grabitz SD, Gradwohl-Matis I, et al. Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial. Lancet. 2016;388(10052):1377–88 Outstanding trial which demonstrated the importance of goal-directed mobility with a coordinated team approach to achieving mobility within the surgical ICU setting.PubMedCrossRef

80.•

Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874–82 Landmark trial which demonstrated that early physical and occupational therapy improves physical outcomes in the ICU population.PubMedCrossRef

81.

Seo B, Shin W-S. Effects of functional training on strength, function level, and quality of life of persons in intensive care units. Phys Ther Rehabil Sci. 2019;8(3):134–40.CrossRef

82.

Schujmann DS, Teixeira Gomes T, Lunardi AC, Zoccoler Lamano M, Fragoso A, Pimentel M, et al. Impact of a progressive mobility program on the functional status, respiratory, and muscular systems of ICU patients: a randomized and controlled trial. Crit Care Med. 2020;48(4):491–7.PubMedCrossRef

83.•

Wright SE, Thomas K, Watson G, Baker C, Bryant A, Chadwick TJ, et al. Intensive versus standard physical rehabilitation therapy in the critically ill (EPICC): a multicentre, parallel-group, randomised controlled trial. Thorax. 2018;73(3):213–21 Trial with important implications for the field in terms of the ability to achieve higher intensities of intervention within the ICU setting based on the challenges of intervention delivery.PubMedCrossRef

84.

Yosef-Brauner O, Adi N, Ben Shahar T, Yehezkel E, Carmeli E. Effect of physical therapy on muscle strength, respiratory muscles and functional parameters in patients with intensive care unit-acquired weakness. Clin Respir J. 2015;9(1):1–6.PubMedCrossRef

85.

Vina J, Sanchis-Gomar F, Martinez-Bello V, Gomez-Cabrera MC. Exercise acts as a drug; the pharmacological benefits of exercise. Br J Pharmacol. 2012;167(1):1–12.PubMedPubMedCentralCrossRef

86.•

Hayward KS, Churilov L, Dalton EJ, Brodtmann A, Campbell BCV, Copland D, et al. Advancing stroke recovery through improved articulation of nonpharmacological intervention dose. Stroke. 2021;52(2):761–9 Framework from stroke population on how dose articulation can be described and reported in trials.PubMedCrossRef

87.•

Scheffenbichler FT, Teja B, Wongtangman K, Mazwi N, Waak K, Schaller SJ, et al. Effects of the level and duration of mobilization therapy in the surgical ICU on the loss of the ability to live independently: an international prospective cohort study. Crit Care Med. 2021;49(3):e247–e57 Cohort multi-centre study demonstrating that a higher dose of mobilisation is an independent predictor of the ability to live independently after discharge.PubMedPubMedCentralCrossRef

88.

Ding N, Zhang Z, Zhang C, Yao L, Yang L, Jiang B, et al. What is the optimum time for initiation of early mobilization in mechanically ventilated patients? A network meta-analysis. PLoS One. 2019;14(10):e0223151.PubMedPubMedCentralCrossRef

89.•

Paton M, Lane R, Paul E, Cuthburtson GA, Hodgson CL. Mobilization during critical illness: a higher level of mobilization improves health status at 6 months, a secondary analysis of a prospective cohort study. Crit Care Med. 2021;49(9):e860–e9 Cohort multi-centre study demonstrating higher levels of mobility but not increasing frequency of sessions improved health status 6 months after ICU admission.PubMedCrossRef

90.

Schaller SJ, Scheffenbichler FT, Bose S, Mazwi N, Deng H, Krebs F, et al. Influence of the initial level of consciousness on early, goal-directed mobilization: a post hoc analysis. Intensive Care Med. 2019;45(2):201–10.PubMedCrossRef

91.•

Parry SM, Berney S, Granger CL, Koopman R, El-Ansary D, Denehy L. Electrical muscle stimulation in the intensive care setting: a systematic review. Crit Care Med. 2013;41(10):2406–18 Comprehensive systematic review synthesising the literature regarding electrical muscle stimulation interventions within the ICU setting.PubMedCrossRef

92.

Burke D, Gorman E, Stokes D, Lennon O. An evaluation of neuromuscular electrical stimulation in critical care using the ICF framework: a systematic review and meta-analysis. Clin Respir J. 2016;10(4):407–20.PubMedCrossRef

93.••

Zhou W, Yu L, Fan Y, Shi B, Wang X, Chen T, et al. Effect of early mobilization combined with early nutrition on acquired weakness in critically ill patients (EMAS): a dual-center, randomized controlled trial. PLoS One. 2022;17(5):e0268599 An RCT of early mobilisation compared to early mobilisation and early nutrition intervention compared to usual care on ICU acquired weakness. Both intervention groups reduced ICU-acquired weakness compared to usual care.PubMedPubMedCentralCrossRef

94.••

de Azevedo JRA, Lima HCM, Frota P, Nogueira I, de Souza SC, Fernandes EAA, et al. High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes. BMC Anesthesiol. 2021;21(1):283 An RCT in mechanically ventilated patients which combined an augmented protein intervention with cycle ergometry compared to standard care, with improved physical function at 3 months in the intervention group.PubMedPubMedCentralCrossRef

95.

Heyland DK, Day A, Clarke GJ, Hough CT, Files DC, Mourtzakis M, et al. Nutrition and exercise in critical illness trial (NEXIS trial): a protocol of a multicentred, randomised controlled trial of combined cycle ergometry and amino acid supplementation commenced early during critical illness. BMJ Open. 2019;9(7):e027893.PubMedPubMedCentralCrossRef

96.

Amundadottir OR, Jonasdottir RJ, Sigvaldason K, Jonsdottir H, Moller AD, Dean E, et al. Predictive variables for poor long-term physical recovery after intensive care unit stay: an exploratory study. Acta Anaesthesiol Scand. 2020;64(10):1477–90.PubMedCrossRef

97.•

Needham DM, Sepulveda KA, Dinglas VD, Chessare CM, Friedman LA, Bingham CO 3rd, et al. Core outcome measures for clinical research in acute respiratory failure survivors. An International Modified Delphi Consensus Study. Am J Respir Crit Care Med. 2017;196(9):1122–30 Delphi consensus recommendations for core outcomes in clinical research for acute respiratory failure survivors.PubMedPubMedCentralCrossRef

98.

Spies CD, Krampe H, Paul N, Denke C, Kiselev J, Piper SK, et al. Instruments to measure outcomes of post-intensive care syndrome in outpatient care settings – results of an expert consensus and feasibility field test. J Intensive Care Soc. 2021;22(2):159–74.PubMedCrossRef

99.

Connolly B, Denehy L, Hart N, Pattison N, Williamson P, Blackwood B. Physical Rehabilitation Core Outcomes In Critical illness (PRACTICE): protocol for development of a core outcome set. Trials. 2018;19(1):294.PubMedPubMedCentralCrossRef

100.

Puthucheary Z, Davies T. Core outcome measures for clinical effectiveness trials of nutritional and metabolic interventions in critical illness: an International Modified Delphi Consensus Study Evaluation (CONCISE) 2022 [Available from: https://www.comet-initiative.org/Studies/Details/1838.

101.

Chapple LS, Deane AM, Heyland DK, Lange K, Kranz AJ, Williams LT, et al. Energy and protein deficits throughout hospitalization in patients admitted with a traumatic brain injury. Clin Nutr. 2016.

102.

Ridley EJ, Parke RL, Davies AR, Bailey M, Hodgson C, Deane AM, et al. What happens to nutrition intake in the post-intensive care unit hospitalization period? An observational cohort study in critically ill adults. JPEN J Parenter Enteral Nutr. 2019;43(1):88–95.PubMedCrossRef

103.

Gupta P, Martin JL, Needham DM, Vangala S, Colantuoni E, Kamdar BB. Use of actigraphy to characterize inactivity and activity in patients in a medical ICU. Heart Lung. 2020;49(4):398–406.PubMedPubMedCentralCrossRef

Title: Attenuating Muscle Mass Loss in Critical Illness: the Role of Nutrition and Exercise
Authors: Lee-anne S. Chapple
Selina M. Parry
Stefan J. Schaller
Publication date: 31-08-2022
Publisher: Springer US
Keyword: Nutrition
Published in: Current Osteoporosis Reports / Issue 5/2022
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI: https://doi.org/10.1007/s11914-022-00746-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Attenuating Muscle Mass Loss in Critical Illness: the Role of Nutrition and Exercise

Abstract

Purpose of Review

Recent Findings

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 5/2022

Periosteal Skeletal Stem and Progenitor Cells in Bone Regeneration

Correction to: Stopping Denosumab

Muscle and Bone Defects in Metastatic Disease

Exercise and Exercise Mimetics for the Treatment of Musculoskeletal Disorders

Correction to: Fracture Prediction by Computed Tomography and Finite Element Analysis: Current and Future Perspectives

Functional Heterogeneity Within Osteoclast Populations—a Critical Review of Four Key Publications that May Change the Paradigm of Osteoclasts