Novel approaches to metabolic assessment and structured exercise to promote recovery in ICU survivors.

Journal Article (Journal Article;Review)

PURPOSE OF REVIEW: Survivorship or addressing impaired quality of life (QoL) in ICU survivors has been named 'the defining challenge of critical care' for this century to address this challenge; in addition to optimal nutrition, we must learn to employ targeted metabolic/muscle assessment techniques and utilize structured, progressive ICU rehabilitative strategies. RECENT FINDINGS: Objective measurement tools such as ccardiopulmonary exercise testing (CPET) and muscle-specific ultrasound show great promise to assess/treat post-ICU physical dysfunction. CPET is showing that systemic mitochondrial dysfunction may underlie development and persistence of poor post-ICU functional recovery. Finally, recent data indicate that we are poor at delivering effective, early ICU rehabilitation and that there is limited benefit of currently employed later ICU rehabilitation on ICU-acquired weakness and QoL outcomes. SUMMARY: The combination of nutrition with effective, early rehabilitation is highly likely to be essential to optimize muscle mass/strength and physical function in ICU survivors. Currently, technologies such as muscle-specific ultrasound and CPET testing show great promise to guide ICU muscle/functional recovery. Further, we must evolve improved ICU-rehabilitation strategies, as current methods are not consistently improving outcomes. In conclusion, we must continue to look to other areas of medicine and to athletes if we hope to ultimately improve 'ICU Survivorship'.

Full Text

Duke Authors

Cited Authors

  • Molinger, J; Pastva, AM; Whittle, J; Wischmeyer, PE

Published Date

  • August 2020

Published In

Volume / Issue

  • 26 / 4

Start / End Page

  • 369 - 378

PubMed ID

  • 32568800

Pubmed Central ID

  • PMC8104451

Electronic International Standard Serial Number (EISSN)

  • 1531-7072

Digital Object Identifier (DOI)

  • 10.1097/MCC.0000000000000748

Language

  • eng

Conference Location

  • United States