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Project

Impact of acute and possibly permanent neuro-endocrine changes on critical illness induced muscle weakness and its legacy

Patients admitted to an intensive care unit (ICU) are at high risk for developing muscle weakness,  jeopardizing short-term and long-term recovery, up to years after the initial event. Treatment options are very limited. We recently performed a large
randomized clinical trial (EPaNIC) that demonstrated that accepting low caloric intake in the first week in ICU (intervention) reduced the incidence of weakness compared to early artificial substitution of caloric deficits (control).
Weakness may be linked to changes in hormone levels during critical illness. These alterations occur in two different phases. The acute phase appears similar to what is seen when healthy persons fast and possibly protects against damage. The prolonged phase is characterized by low hormone levels and could be detrimental, promoting muscle weakness.
We will study whether the protective effect of the intervention group in the EPaNIC trial on weakness was mediated by a more pronounced “fasting type” acute hormonal response. We also hypothesize that hormonal changes during critical illness relate to muscle atrophy and injury and that the prolonged changes in hormones contribute to non-recovery of muscle weakness by the end of the ICU stay. Finally, we postulate that persisting hormonal changes up to 5 years following ICU stay relate with persisting functional limitations. This project therefore may offer opportunities to discover treatments for this devastating complication.

Date:1 Jan 2020 →  31 Dec 2023
Keywords:intensive care unit, muscle weakness, caloric deficits, hormonal changes
Disciplines:Endocrinology, Surgical intensive care, Medical intensive care