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Novel approaches to metabolic assessment and structured exercise to promote recovery in ICU survivors
- Source :
- Current Opinion in Critical Care, 26(4), 369-378. Lippincott Williams & Wilkins, Curr Opin Crit Care
- Publication Year :
- 2020
- Publisher :
- Lippincott Williams & Wilkins, 2020.
-
Abstract
- 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'.
- Subjects :
- Weakness
medicine.medical_specialty
medicine.medical_treatment
health care facilities, manpower, and services
Critical Illness
MEDLINE
Physical function
Critical Care and Intensive Care Medicine
Article
03 medical and health sciences
0302 clinical medicine
Quality of life
Survivorship curve
Medicine
Humans
Survivors
Intensive care medicine
Exercise
Rehabilitation
biology
business.industry
Athletes
030208 emergency & critical care medicine
biology.organism_classification
Intensive Care Units
030228 respiratory system
Optimal nutrition
Quality of Life
medicine.symptom
business
Subjects
Details
- Language :
- English
- ISSN :
- 15317072 and 10705295
- Volume :
- 26
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Current Opinion in Critical Care
- Accession number :
- edsair.doi.dedup.....f351869d47dc13ad8887972deb7d34a5