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Role of anabolic testosterone agents and structured exercise to promote recovery in ICU survivors

Authors :
Oscar E. Suman
Steven E. Wolf
Jeroen Molinger
Amy M. Pastva
Rosemary A. Kozar
Paul E. Wischmeyer
Intensive Care
Source :
Curr Opin Crit Care, Current Opinion in Critical Care, 26(5), 508-515. Lippincott Williams & Wilkins
Publication Year :
2020

Abstract

PURPOSE OF REVIEW: Intensive Care Unit (ICU) survivors frequently suffer significant, prolonged physical disability. ‘ICU Survivorship’, or addressing quality of life impairments post-ICU care, is a defining challenge, and existing standards of care fail to successfully address these disabilities. We suggest addressing persistent catabolism by treatment with testosterone analogs combined with structured exercise is a promising novel intervention to improve “ICU Survivorship”. RECENT FINDINGS: One explanation for lack of success in addressing post-ICU physical disability is most ICU patients exhibit severe testosterone deficiencies early in ICU that drives persistent catabolism despite rehabilitation efforts. Oxandrolone is an FDA-approved testosterone analogue for treating muscle weakness in ICU patients. A growing number of trials with this agent combined with strutured exercise show clinical benefit, including improved physical function and safety in burns and other catabolic states. However, no trials of oxandrolone/testosterone and exercise in non-burn ICU populations have been conducted. SUMMARY: Critical illness leads to a catabolic state, including severe testosterone deficiency that persists throughout hospital stay, and results in persistent muscle weakness and physical dysfunction. The combination of an anabolic agent with adequate nutrition and structured exercise is likely essential to optimize muscle mass/strength and physical function in ICU survivors. Further research in ICU populations is needed.

Details

ISSN :
15317072 and 10705295
Volume :
26
Issue :
5
Database :
OpenAIRE
Journal :
Current opinion in critical care
Accession number :
edsair.doi.dedup.....5380a90b069f7acc1098dec01f719f51