scholarly journals Sparing of muscle mass and function by passive loading in an experimental intensive care unit model

2013 ◽  
Vol 591 (5) ◽  
pp. 1385-1402 ◽  
Author(s):  
Guillaume Renaud ◽  
Monica Llano-Diez ◽  
Barbara Ravara ◽  
Luisa Gorza ◽  
Han-Zhong Feng ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Muscle Mass ◽  
Unit Model ◽  
And Function

scholarly journals Assessment of Sarcopenia in the Intensive Care Unit and 1-Year Mortality in Survivors of Critical Illness

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2726
Author(s):  
Naoya Yanagi ◽  
Tomotaka Koike ◽  
Kentaro Kamiya ◽  
Nobuaki Hamazaki ◽  
Kohei Nozaki ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Cox Regression ◽  
Study Endpoint ◽  
Icu Discharge ◽  
And Function

Skeletal muscle wasting in the intensive care unit (ICU) has been associated with mortality, but it is unclear whether sarcopenia, defined by skeletal muscle mass and function, is useful for detailed risk stratification after ICU discharge. In this cohort study, 72 critically ill patients with an ICU stay of ≥48 h were identified. Skeletal muscle mass was assessed from the muscle thickness (MT) of the patients’ quadriceps using ultrasound images before ICU discharge. Skeletal muscle function was assessed from the patients’ muscle strength (MS) before ICU discharge according to the Medical Research Council sum score. A diagnosis of sarcopenia in the ICU was made in patients with low MT and low MS. The study endpoint was 1-year mortality. Sarcopenia in the ICU was diagnosed in 26/72 patients (36%). After adjusting for covariates in the Cox regression, sarcopenia in the ICU was significantly associated with 1-year mortality (hazard ratio 3.82; 95% confidence interval, 1.40–10.42). Sarcopenia in the ICU, defined by low skeletal muscle mass and function, was associated with 1-year mortality in survivors of critical illness. Skeletal muscle mass and function assessed at the bedside could be used to identify higher-risk patients in the ICU.

scholarly journals Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations

2021 ◽  
Author(s):  
Gianmarco Secco ◽  
◽  
Marzia Delorenzo ◽  
Francesco Salinaro ◽  
Caterina Zattera ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Structure And Function ◽  
General Ward ◽  
Prognostic Role ◽  
Interstitial Syndrome ◽  
Lung Structure ◽  
And Function ◽  
The Relationship

AbstractBedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R2 0.68; p < 0.0001) and P/F at FiO2 = 21% (R2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function.

scholarly journals ROUNDS Studies: Relation of OUtcomes with Nutrition Despite Severity—Round One: Ultrasound Muscle Measurements in Critically Ill Adult Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Carlos Alfredo Galindo Martín ◽  
Reyna del Carmen Ubeda Zelaya ◽  
Enrique Monares Zepeda ◽  
Octavio Augusto Lescas Méndez
Keyword(s):  
Intensive Care Unit ◽  
Logistic Regression ◽  
Intensive Care ◽  
Muscle Mass ◽  
Sofa Score ◽  
Protective Factor ◽  
Severity Of Illness ◽  
Muscle Thickness ◽  
Rectus Femoris ◽  
Adult Patients

Malnutrition (undernutrition) encompasses low intake or uptake, loss of fat mass, and muscle wasting and is associated with worse outcomes. Ultrasound has been introduced in the intensive care unit as a tool to assess muscle mass. The aim of the present study is to explore the relation between initial muscle mass and mortality in adult patients admitted to the intensive care unit. Methods. Rectus femoris and vastus intermedius thicknesses were measured by B-mode ultrasound in adult patients at admission, along with demographic characteristics, illness severity, comorbidities, biochemical variables, treatments, and in-hospital mortality as main outcomes. Analysis was made comparing survivors versus nonsurvivors and finally using binary logistic regression with mortality as dependent variable. Results. 59 patients were included in the analysis, severity measured by sequential organ failure assessment (SOFA) score was greater in nonsurvivors (17 (7) versus 24 (10) and 3 (1–5) versus 7 (3–10), resp.). Also, muscle thickness was lower in the latter group (1.44 (0.59) cm versus 0.98 (0.3) cm). Logistic regression showed severity by SOFA score as a risk factor and muscle thickness as a protective factor for mortality. Conclusion. Muscle mass showed to be a protective factor despite severity of illness; there is much more work to do regarding interventions and monitoring in order to prevent or overcome low muscle mass at admission to the intensive care unit.

EFFECTS OF A CLOSED INTENSIVE CARE UNIT MODEL ON PATIENT CARE OUTCOMES

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 109P
Author(s):  
Gregory H. Howell ◽  
Nichole Clark ◽  
Gary Salzman ◽  
Aaron J. Bonham
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Unit Model ◽  
Care Outcomes

scholarly journals Detection of Sepsis in Platelets Using MicroRNAs and Membrane Antigens

Genes ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 1877
Author(s):  
Priscilla Cristina Moura Vieira Corrêa ◽  
Débora Monteiro Carneiro ◽  
Luciana do Socorro da Silva Valente ◽  
Fabíola Marques Diogo ◽  
Leticia Martins Lamarão ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Platelet Activation ◽  
Inverse Relationship ◽  
Diagnostic Parameters ◽  
Negative Results ◽  
Blood Banks ◽  
Membrane Antigens ◽  
And Function

The present study proposes to legitimize in sepsis a characteristic found in platelets that suffer storage lesions in blood banks, which is the increased expression of miRNA miR-320a in relation to miR-127. Under physiologically normal conditions, an inverse relationship is observed. The aim of this study was to verify whether the analysis of miR-320a and miR-127 expression in platelets could detect a decrease in their viability and function due to the presence of pathogens in the blood of patients hospitalized in the Intensive Care Unit. We also investigated the expression of membrane antigens sensitive to platelet activation. Of the 200 patients analyzed, only those who developed sepsis (140) were found to have a higher relative quantity of miR-320a than that of miR-127. This characteristic and the increased expression of membrane antigens P2Y12, CD62P, CD41, and CD61 showed a significant association (p < 0.01) with all types of sepsis evaluated in this study. Additionally, 40% of patients hospitalized for sepsis had negative results for the first cultures. We conclude that analysis of miR-127 and miR-320a expression combined with membrane antigens evaluation, in association with the available clinical and diagnostic parameters, are important tools to detect the onset of sepsis.

Comparison of outcome predictions made by physicians, by nurses, and by using the Mortality Prediction Model

2001 ◽  
Vol 10 (5) ◽  
pp. 313-319 ◽  
Author(s):  
L Copeland-Fields ◽  
T Griffin ◽  
T Jenkins ◽  
M Buckley ◽  
LC Wise
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prediction Model ◽  
Clinical Judgment ◽  
Mortality Prediction ◽  
Survival Outcomes ◽  
Emergency Physicians ◽  
Nursing Experience ◽  
Mortality Prediction Model ◽  
And Function

BACKGROUND: Critical care nurses must collaborate with physicians, patients, and patients' families when making decisions about aggressiveness of care. However, few studies address nurses' ability to predict outcomes. OBJECTIVES: To compare predictions of survival outcomes made by nurses, by physicians, and by using the Mortality Prediction Model. METHODS: Predictions of survival and function and attitudes toward aggressiveness of care based on the predictions were recorded on questionnaires in the emergency department by emergency and intensive care unit physicians and by intensive care unit nurses at the time of admission to the unit between February and September 1995 for 235 consecutive adult nontrauma patients. Scores on the Mortality Prediction Model were calculated on admission. Data on 85 of the 235 patients were analyzed by using descriptive, chi 2, and correlational statistics. Nurses' predictions of function were compared with patients' actual outcomes 6 months after admission. RESULTS: Nurses' predictions of survival were comparable to those of emergency physicians and superior to those obtained by using the objective tool. Years of nursing experience had no relationship to attitudes toward aggressiveness of care. Nurses accurately predicted functional outcomes in 52% of the followed-up cases. Intensive care physicians were more accurate than nurses and emergency physicians in predicting survival. All predictions made by clinicians were superior to those obtained by using the model. CONCLUSIONS: Nurses can predict survival outcomes as accurately as physicians do. Greater sensitivity and specificity are necessary before clinical judgment or predictive tools can be considered as screens for determining aggressiveness of care.

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