scholarly journals Thoracic Skeletal Muscle Quantification Using Computed Tomography And Prognosis Of Elderly ICU Patients

2021 ◽  
Author(s):  
Sung Woo Moon ◽  
Song Yee Kim ◽  
Ji Soo Choi ◽  
Ah Young Leem ◽  
Su Hwan Lee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Sofa Score ◽  
Pectoralis Muscle ◽  
Muscle Loss ◽  
Icu Patients ◽  
Icu Admission ◽  
Prolonged Ventilation ◽  
Skeletal Muscle Loss

Abstract Background: In elderly ICU patients, the prevalence of skeletal muscle loss is high. And the consequences of skeletal muscle loss can be severe in elderly. Correlations have been found between the muscle cross-sectional area (CSA) at a single thoracic level on chest computed tomography (CT). Correlation between thoracic muscle mass and mortality has been found in ICU patients. But longitudinal effect of thoracic muscles especially in elderly ICU patients are unclear although skeletal muscle loss is related with the short- and long-term outcomes. Objective: This study aimed to evaluate whether pectoralis muscle mass could be a predictor of prognosis in elderly ICU patients.Methods: We retrospectively evaluated 190 elderly patients admitted in the ICU between January 2010 and December 2015 in one tertiary care hospital in South Korea. We measured the CSA of the pectoralis muscle area (PMCSA) at the fourth vertebral region. CT scans within two days before ICU admission were used for analysis. Mortality, prolonged mechanical ventilation, and longitudinal change in Sequential Organ Failure Assessment (SOFA) scores were examined. Multivariate logistic regression, linear mixed, and multivariate Cox proportional hazards models were used.Results: PMCSA below median was significantly related with prolonged ventilation. (odds ratio 2.92, 95% CI: 1.02-1.42, P=0.06) and a higher SOFA score during the ICU stay (estimated mean = 0.94, P = 0.03). PMCSA below median was a significant risk for all-cause mortality (HR: 2.06, 95% CI: 1.23-3.47, P=0.01)Conclusions: In elderly ICU patients, low ICU admission PMCSA was associated with prolonged ventilation, a higher SOFA score during the ICU stay and higher mortality. Adding thoracic skeletal muscle CSA at the time of ICU admission into consideration in deciding therapeutic intensity in elderly ICU patients may help in making medical decisions.

scholarly journals Thoracic skeletal muscle quantification using computed tomography and prognosis of elderly ICU patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sung Woo Moon ◽  
Song Yee Kim ◽  
Ji Soo Choi ◽  
Ah Young Leem ◽  
Su Hwan Lee ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Prolonged Mechanical Ventilation ◽  
Significant Risk ◽  
Pectoralis Muscle ◽  
Muscle Loss ◽  
Icu Patients ◽  
Icu Admission ◽  
Icu Stay ◽  
Prolonged Ventilation ◽  
Skeletal Muscle Loss

AbstractIn elderly ICU patients, the prevalence of skeletal muscle loss is high. Longitudinal effect of thoracic muscles, especially in elderly ICU patients, are unclear although skeletal muscle loss is related with the short- and long-term outcomes. This study aimed to evaluate whether pectoralis muscle mass loss could be a predictor of prognosis in elderly ICU patients. We retrospectively evaluated 190 elderly (age > 70 years) patients admitted to the ICU. We measured the cross-sectional area (CSA) of the pectoralis muscle (PMCSA) at the fourth vertebral region. CT scans within two days before ICU admission were used for analysis. Mortality, prolonged mechanical ventilation, and longitudinal changes in Sequential Organ Failure Assessment (SOFA) scores were examined. PMCSA below median was significantly related with prolonged ventilation (odds ratio 2.92) and a higher SOFA scores during the ICU stay (estimated mean = 0.94). PMCSA below median was a significant risk for hospital mortality (hazards ratio 2.06). In elderly ICU patients, a low ICU admission PMCSA was associated with prolonged ventilation, higher SOFA score during the ICU stay, and higher mortality. Adding thoracic skeletal muscle CSA at the time of ICU admission into consideration in deciding the therapeutic intensity in elderly ICU patients may help in making medical decisions.

scholarly journals Skeletal Muscle Loss during Multikinase Inhibitors Therapy: Molecular Pathways, Clinical Implications, and Nutritional Challenges

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3101
Author(s):  
Emanuele Rinninella ◽  
Marco Cintoni ◽  
Pauline Raoul ◽  
Carmelo Pozzo ◽  
Antonia Strippoli ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Muscle Mass ◽  
Nutritional Support ◽  
Muscle Wasting ◽  
Early Recognition ◽  
Clinical Implications ◽  
Molecular Pathways ◽  
Muscle Loss ◽  
Skeletal Muscle Loss ◽  
The Impact

In cancer patients, loss of muscle mass is significantly associated with low tolerability of chemotherapy and poor survival. Despite the great strides in the treatment of cancer, targeted therapies such as tyrosine kinase inhibitors (TKIs) could exacerbate muscle wasting. Over recent years, the impact of skeletal muscle loss during TKI therapy on clinical outcomes has been in the spotlight. In this review, we focus on the different molecular pathways of TKIs potentially involved in muscle wasting. Then, we report the results of the studies assessing the effects of different TKI therapies—such as sorafenib, regorafenib, sunitinib, and lenvatinib—on muscle mass, and highlight their potential clinical implications. Finally, we discuss an integrative nutritional approach to be adopted during TKI treatment. The assessment of muscle mass from computerized tomography imaging could be helpful in predicting toxicity and prognosis in patients treated with TKI such as sorafenib. Early recognition of low muscle mass and effective personalized nutritional support could prevent or attenuate muscle mass wasting. However, the role of nutrition is still overlooked, and future clinical trials are needed to find the optimal nutritional support to countermeasure muscle mass depletion during TKI therapy.

Skeletal muscle loss after total gastrectomy, exacerbated by adjuvant chemotherapy.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 168-168
Author(s):  
Kazumasa Fujitani ◽  
Yusuke Yamaoka ◽  
Toshimasa Tsujinaka ◽  
Kazuyoshi Yamamoto ◽  
Motohiro Hirao ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Adipose Tissue ◽  
Adjuvant Chemotherapy ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Significant Loss ◽  
Muscle Loss ◽  
Clinical Factors ◽  
Improved Outcomes ◽  
Skeletal Muscle Loss

168 Background: Skeletal muscle loss is associated with physical disability, nosocomial infections, postoperative complications, and decreased survival. Preventing the loss of skeletal muscle mass after gastrectomy may lead to improved outcomes. The aims of this study were to assess changes in skeletal muscle mass after total gastrectomy (TG) and to clarify the clinical factors affecting significant loss of skeletal muscle after TG. Methods: One hundred and two patients undergoing TG for primary gastric cancer underwent abdominal computed tomography (CT) before and 1 year after TG to precisely quantify postoperative changes in skeletal muscle and adipose tissue. Univariate and multivariate logistic regression analyses identified clinical factors contributing to significant loss of skeletal muscle after TG. Results: At 1 year after TG, the mass of both skeletal muscle and adipose tissue was reduced by 6.20±6.80% and 65.8±36.1% of the preoperative values, respectively, and 26 patients (25.5%) showed a significant loss of skeletal muscle of more than 10%. Adjuvant chemotherapy with S-1 for ≥6 months (hazard ratio 26.75, 95% confidence interval 3.511 to 203.9) was identified as the single independent risk factor for a significant loss of skeletal muscle. Conclusions: Skeletal muscle loss was exacerbated by extended adjuvant chemotherapy after TG. Further research should identify appropriate nutritional interventions for maintaining skeletal muscle mass and leading to improved outcomes.

scholarly journals Skeletal muscle loss was associated with the risk of diabetes in non non-alcoholic fatty liver disease Chinese male middle-aged and elderly population, the Shanghai Changfeng Study

2021 ◽  
Author(s):  
Lingyan Chen ◽  
Mingfeng Xia ◽  
Li Wu ◽  
Qian Li ◽  
Yu Hu ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Logistic Regression ◽  
Liver Disease ◽  
Muscle Mass ◽  
Fatty Liver Disease ◽  
Skeletal Muscle Mass ◽  
Muscle Loss ◽  
Alcoholic Fatty Liver ◽  
Skeletal Muscle Loss ◽  
Alcoholic Fatty Liver Disease

Abstract Background Previous studies have presented skeletal muscle loss was associated with diabetes mellitus (DM) and non-alcoholic fatty liver disease (NAFLD). However, whether the presence of NAFLD could influence the association between skeletal muscle mass and DM was still unknown. The aim of the present study was to investigate the relationship of skeletal muscle mass with diabetes in Chinese middle-aged and older community population, and whether the association could be effected by NAFLD. Methods A cross-sectional study of 5,626 residents aged 45 and above in Changfeng community in Shanghai were conducted. Skeletal muscle mass (SMM) was detected by dual-energy X ray absorption (DXA) and calculated as ASM% [appendicular skeletal muscle mass (ASM) (kg) /body weight*100%]. Liver fat content (LFC) was measured using a quantitative ultrasound method. Multivariate logistic regression analyses were conducted to investigate the association between ASM% quartiles with DM. Results With ASM% decreasing, fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hBG) and Homeostasis model assessment for insulin resistance (HOMA-IR) as well as LFC increased in both genders, and the prevalence of diabetes and NAFLD also increased. Spearman analysis showed ASM% was negatively correlated with FBG, 2hBG and LFC. Stepwise logistic regression analysis showed after multiple adjustments, ASM% quartile was negatively associated with the risk of diabetes only in male, but not in female. Subgroup analysis found the ASM% quartiles remained negatively correlated with the risk of diabetes in male non-NAFLD population, but not in NAFLD population. When stratified by LFC quartiles, the results was similar. After multivariate adjustments, low ASM% was negatively correlated with the risk of diabetes only in the first and second LFC quartile in male, and the association remained insignificant in each LFC quartile in female. Conclusions Skeletal muscle mass was negatively associated with the risk of diabetes in male population but not in female. The presence of NAFLD weakened this association. The results suggested stratified management of diabetes should be considered according to skeletal muscle mass and the presence of NAFLD.

Time course of skeletal muscle loss and oxidative stress in rats with walker 256 solid tumor

2010 ◽  
Vol 42 (6) ◽  
pp. 950-958 ◽  
Author(s):  
Flávia A. Guarnier ◽  
Alessandra L. Cecchini ◽  
Andréia A. Suzukawa ◽  
Ana Leticia G.C. Maragno ◽  
Andréa N.C. Simão ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Skeletal Muscle ◽  
Solid Tumor ◽  
Time Course ◽  
Muscle Loss ◽  
Skeletal Muscle Loss ◽  
Walker 256 ◽  
And Oxidative Stress

Skeletal muscle loss and prognosis of breast cancer patients

2017 ◽  
Vol 25 (7) ◽  
pp. 2221-2227 ◽  
Author(s):  
Yoshiko Kubo ◽  
Tateaki Naito ◽  
Keita Mori ◽  
Gakuji Osawa ◽  
Etsuko Aruga
Keyword(s):  
Breast Cancer ◽  
Skeletal Muscle ◽  
Cancer Patients ◽  
Muscle Loss ◽  
Breast Cancer Patients ◽  
Skeletal Muscle Loss

scholarly journals Interim-analysis of the COSA (COVID-19 patients treated with the Seraph® 100 Microbind® Affinity filter) registry

2021 ◽  
Author(s):  
Julius J Schmidt ◽  
Dan Nicolae Borchina ◽  
Mariet van´t Klooster ◽  
Khalida Bulhan-Soki ◽  
Reuben Okioma ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Sofa Score ◽  
Cox Regression ◽  
Treatment Time ◽  
Outcome Data ◽  
Adverse Outcomes ◽  
Icu Patients ◽  
Icu Admission ◽  
Late Initiation ◽  
Bacterial Superinfection

Abstract Background The Seraph®100 Microbind Affinity Blood Filter® is a hemoperfusion device that is licensed for the reduction of pathogens, including several viruses, in the blood. It received Emergency Use Authorization (EUA) for the treatment of severe coronavirus disease 2019 (COVID-19) by the FDA. Several studies have shown that the blood viral load of SARS-CoV-2 correlates with adverse outcomes and removal of the nucleocapsid of the SARS-CoV-2 virus by the Seraph®100 has been recently demonstrated. The aim of this registry was to evaluate safety and efficacy of Seraph®100 treatment for COVID-19 patients. Methods Twelve hospitals from six countries representing two continents documented patient and treatment characteristics as well as outcome parameters without reimbursement. Additionally, mortality and safety results of the device were reported. One hundred-and-two treatment sessions in 82 patients were documented in the registry. Four patients were excluded from mortality analysis due to incomplete outcome data, which were available in the other 78 patients. Results Overall, a 30-day mortality rate of 46.2% in the 78 patients with complete follow up was reported. Median treatment time was 5.00 [4.00–13.42] h. and 43.1% of the treatments were performed as hemoperfusion only. Adverse events of the Seraph®100 treatment were reported in 8.8% of the 102 treatments and represented premature end of treatment due to circuit failure. Patients that died were treated later in their ICU stay and onset of COVID symptoms. They also had higher ferritin levels. Multivariate Cox regression revealed that delayed Seraph®100 treatment after ICU admission (>60 hours) as well as bacterial superinfection were associated with mortality. While average predicted mortality rate according to SOFA score in ICU patients was 56.7% the observed mortality was 50.7%. In non-ICU patients 4C-Score average predicted a mortality rate of 38.0% while the observed mortality rate was 11.1% Conclusions The treatment of COVID-19 patients with Seraph®100 is well tolerated and the circuit failure rate was lower than previously reported for KRT in COVID-19 patients. Mortality corelated with late initiation of Seraph treatment after ICU admission and bacterial superinfection infection. Compared to predicted mortality according to 4C-Score and SOFA Score, mortality of Seraph®100 treated patients reported in the registry was lower.

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