ICU sedation, delirium & recovery
Inflammation and altered metabolism impede efficacy of functional electrical stimulation in critically ill patients
Authors' conclusion
Intramuscular inflammation and altered substrate utilization are persistent in skeletal muscle during first week of critical illness and are not improved by the application of Functional Electrical Stimulation-assisted exercise.
Study context
- Population
- Critically ill ICU patients; healthy volunteers undergoing elective hip arthroplasty
- Comparison
- Functional electrical stimulation (FES) cycling vs no FES
- Outcome
- Skeletal muscle mRNA expression of 223 genes
- Follow-up
- Admission to day 7
Methodological detailsnested muscle biopsy studies of two randomised controlled trials, single-centre primary cohort, four-centre validation cohort
- Nested muscle biopsy studies of two randomised controlled trials
- Single-centre primary cohort
- Four-centre validation cohort
Main finding
As reported in the abstract
Muscle mRNA expression, admission vs day 7 · day 7
- FOXO-mediated transcription (mean log2 fold change ± SD): admission 0.48 ± 0.94, day 7 - 0.47 ± 1.04
- P = 0.042
- Fatty acid metabolism: admission 0.50 ± 0.67, day 7 0.07 ± 1.65
- P = 0.042
- Interleukin-1 processing: admission 0.88 ± 0.50, day 7 0.97 ± 0.76
- P = 0.054
- UCP3 decreased in both cohorts
- P = 0.030
- DGKD decreased in both cohorts
- P = 0.040
- IL-18 change not observed in validation cohort
- P = 0.268
- PPARγ-C1α decreased in both arms
- P < 0.001
- SLC25A20 decreased in both arms
- P = 0.017
- UCP3 decreased in both arms (targeted)
- P < 0.001
- LPIN-1 decreased
- P < 0.001
- SPT1 decreased
- P = 0.044
- IL-18 increased in both arms
- P = 0.011
- TNFRSF12A increased in both arms
- P = 0.009
- IL-1β decreased in both arms
- P = 0.007
- IL-1R1 decreased in both arms
- P = 0.005
- IL-6R decreased in both arms
- P = 0.001
- No between group differences in any of these
- all p > 0.05
Further findings
Healthy volunteers vs ICU
- Positively enriched pathways: stress response, response to stimuli, protein metabolism
Original publication
Inflammation and altered metabolism impede efficacy of functional electrical stimulation in critically ill patients. Crit Care. Published 6 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →