ICU sedation, delirium & recovery
Preserved anabolic skeletal muscle capacity in response to exercise and protein intake after critical illness
Authors' conclusion
In ICU survivors with persistent muscle loss and weakness, the increase in muscle protein synthesis after combined resistance exercise and protein intake was smaller than in controls, in the context of a higher baseline fractional synthetic rate. Post-intervention muscle protein synthesis rates were similar between groups. These findings provide the first mechanistic support for structured exercise-nutrition rehabilitation to promote muscle recovery after critical illness.
Study context
- Population
- Former intensive care unit patients enrolled within 3 to 6 months of ICU discharge, and controls without a history of critical illnessTwenty ICU survivors and 20 age- and sex-matched controls were included · ICU survivors Twenty · age- and sex-matched controls 20
- Comparison
- Skeletal muscle anabolic response to combined resistance exercise and protein intake in ICU survivors, compared to matched controls without a history of critical illness
- ICU survivorsn = Twenty
- Controlsn = 20
- Outcome
- Between-group difference in pre-to-post change in muscle protein synthesis (from plasma precursor amino acids)
Methodological detailsage- and sex-matched controls, linear mixed models
- Age- and sex-matched controls
- Linear mixed models
Main finding
As reported in the abstract
ICU survivors
Δ 0.031
%/hour
Controls
Δ 0.040
%/hour
P = 0.04
Further findings
| Outcome | ICU survivors | Controls | P value |
|---|---|---|---|
| Quadriceps muscle thickness and handgrip strengthSignificantly lower in ICU survivors | P = 0.02 | ||
| Quadriceps muscle thickness and handgrip strengthSignificantly lower in ICU survivors | P = 0.04 | ||
| Muscle protein synthesis at baselineHigher in ICU survivors | 0.041%/hour | 0.030%/hour | P = 0.009 |
| Post-intervention muscle protein synthesisSimilar between groups | 0.071%/hour | 0.070%/hour | P = 0.70 |
Autophagy-lysosomal pathway activation · baseline
- ICU survivors showed lower activation of the autophagy-lysosomal pathway
Anabolic and proteolytic signalling
- In both groups, the intervention increased anabolic signalling, decreased initiation of autophagy and increased parts of the ubiquitin-proteasome pathway
Original publication
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