Can the critically ill patient generate sufficient energy to facilitate exercise in the ICU?

被引:34
作者
Bear, Danielle E. [1 ,2 ,3 ]
Parry, Selina M. [4 ]
Puthucheary, Zudin A. [5 ,6 ,7 ]
机构
[1] Guys & St Thomas NHS Fdn Trust, Dept Nutr & Dietet, London, England
[2] Guys & St Thomas NHS Fdn Trust, Dept Crit Care, London, England
[3] Guys & St Thomas NHS Fdn Trust, Lane Fox Res Unit, London, England
[4] Univ Melbourne, Dept Physiotherapy, Melbourne, Vic, Australia
[5] UCL, Dept Med, Ctr Human Hlth & Performance, London, England
[6] Royal Free Hosp, Dept Anaesthesia & Intens Care, London, England
[7] Kings Coll London, Ctr Human & Aerosp Physiol Sci, London, England
基金
英国医学研究理事会;
关键词
critically ill; exercise; muscle wasting; nutrition; INTENSIVE-CARE-UNIT; HYDROXY-BETA-METHYLBUTYRATE; PHYSICAL-ACTIVITY; CRITICAL ILLNESS; MUSCLE; REHABILITATION; MORTALITY; SURVIVORS; WEAKNESS; OUTCOMES;
D O I
10.1097/MCO.0000000000000446
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of review Trials of physical rehabilitation post critical illness have yet to deliver improved health-related quality of life in critical illness survivors. Muscle mass and strength are lost rapidly in critical illness and a proportion of patients continue to do so resulting in increased mortality and functional disability. Addressing this issue is therefore fundamental for recovery from critical illness. Recent findings Altered mitochondrial function occurs in the critically ill and is likely to result in decreased adenosine triphosphate (ATP) production. Muscle contraction is a process that requires ATP. The metabolic demands of exercise are poorly understood in the ICU setting. Recent research has highlighted that there is significant heterogeneity in energy requirements between critically ill individuals undertaking the same functional activities, such as sit-to-stand. Nutrition in the critically ill is currently thought of in terms of carbohydrates, fat and protein. It may be that we need to consider nutrition in a more contextual manner such as energy generation or management of protein homeostasis. Summary Current nutritional support practices in critically ill patients do not lead to improvements in physical and functional outcomes, and it may be that alternative methods of delivery or substrates are needed.
引用
收藏
页码:110 / 115
页数:6
相关论文
共 37 条
[31]   Physical declines occurring after hospital discharge in ARDS survivors: a 5-year longitudinal study [J].
Pfoh, Elizabeth R. ;
Wozniak, Amy W. ;
Colantuoni, Elizabeth ;
Dinglas, Victor D. ;
Mendez-Tellez, Pedro A. ;
Shanholtz, Carl ;
Ciesla, Nancy D. ;
Pronovost, Peter J. ;
Needham, Dale M. .
INTENSIVE CARE MEDICINE, 2016, 42 (10) :1557-1566
[32]   Skeletal Muscle Weakness Is Associated With Both Early and Late Mortality After Acute Respiratory Distress Syndrome [J].
Puthucheary, Zudin ;
Prescott, Hallie .
CRITICAL CARE MEDICINE, 2017, 45 (03) :563-565
[33]  
Puthucheary ZA, 2017, AM J RESP CRIT CARE, V195, P136, DOI 10.1164/rccm.201604-0875LE
[34]   Acute Skeletal Muscle Wasting in Critical Illness [J].
Puthucheary, Zudin A. ;
Rawal, Jaikitry ;
McPhail, Mark ;
Connolly, Bronwen ;
Ratnayake, Gamunu ;
Chan, Pearl ;
Hopkinson, Nicholas S. ;
Padhke, Rahul ;
Dew, Tracy ;
Sidhu, Paul S. ;
Velloso, Cristiana ;
Seymour, John ;
Agley, Chibeza C. ;
Selby, Anna ;
Limb, Marie ;
Edwards, Lindsay M. ;
Smith, Kenneth ;
Rowlerson, Anthea ;
Rennie, Michael John ;
Moxham, John ;
Harridge, Stephen D. R. ;
Hart, Nicholas ;
Montgomery, Hugh E. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2013, 310 (15) :1591-1600
[35]   Is There a Role for Enterohormones in the Gastroparesis of Critically Ill Patients? [J].
Santacruz, Carlos A. ;
Quintairos, Amanda ;
Righy, Claudia ;
Crippa, Ilaria A. ;
Couto, Lucio, Jr. ;
Imbault, Virginie ;
Wasineeart, Mongkolpun ;
De Ryckere, Mathieu ;
Preiser, Jean-Charles .
CRITICAL CARE MEDICINE, 2017, 45 (10) :1696-1701
[36]   Effects of β-hydroxy-β-methylbutyrate on skeletal muscle mitochondrial content and dynamics, and lipids after 10 days of bed rest in older adults [J].
Standley, Robert A. ;
Distefano, Giovanna ;
Pereira, Suzette L. ;
Tian, Min ;
Kelly, Owen J. ;
Coen, Paul M. ;
Deutz, Nicolaas E. P. ;
Wolfe, Robert R. ;
Goodpaster, Bret H. .
JOURNAL OF APPLIED PHYSIOLOGY, 2017, 123 (05) :1092-1100
[37]   The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review [J].
Tipping, Claire J. ;
Harrold, Meg ;
Holland, Anne ;
Romero, Lorena ;
Nisbet, Travis ;
Hodgson, Carol L. .
INTENSIVE CARE MEDICINE, 2017, 43 (02) :171-183