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HOW TO WALK OUT OF THE ICU: MUSCLE LOSS & FUNCTION

HOW TO WALK OUT OF THE ICU: MUSCLE LOSS & FUNCTION

How to promote recovery?

Skeletal muscle atrophy and development of ICU acquired weakness are not a specific matter of chronic critical illness but rather have their onset within the first days of acute critical illness. Hence, measures in order to temper the development of neuromuscular organ failure and to promote recovery have to be initiated in the early course of critical illness. Besides a general approach to control for sepsis and systemic inflammation these measures include glycemic control and goal directed nutrition. 


CREDIT: Wollersheim T, Woehlecke J, Krebs M, Hamati J, Lodka D, Luther-Schroeder A, Langhans C, Haas K, Radtke T, Kleber C, Spies C, Labeit S, Schuelke M, Spuler S, Spranger J, Weber-Carstens S, Fielitz J. Dynamics of myosin degradation in intensive care unit-acquired weakness during severe critical illness. Intensive Care Med 2014; 40:528-538

Preventing muscle inactivity plays a key role in promoting physical recovery. PADs management (pain, agitation, delirium) is a requisite in the context of protocol based physiotherapy and early mobilistaion. The latter is associated with improved physical function and long term recovery. Adjunctive measures like electrical muscle stimulation (EMS) provoking muscle contraction especially in the clinical situation of immobilisation are under discussion and will be reviewed within the presentation by Steffen Weber-Carstens.

Take home messages:

• Skeletal muscle atrophy and development of ICU acquired weakness have their onset within the first days of acute critical illness.

• Measures that promote recovery have to be initiated in the early course of critical illness.

• These measures in particular include metabolic control, PADs management as well as protocol driven physiotherapy and early mobilisation.

• Stimulating the immobilised muscle e.g. by electrical muscle stimulation (EMS) may promote recovery. This issue needs further investigation. 

This Thematic Session also includes the following stimulating presentations:

  • Functional assessment  - Nicholas Hart 
  • Comprehensive exercise testing & muscle function  - Julia Wendon 
  • Imaging techniques: US, CT, MRI  - Michael Hiesmayr 
  • Morphological changes - Michael Casear  

Don't miss it...


Thematic Session ~ HOW TO WALK OUT OF THE ICU: MUSCLE LOSS & FUNCTION

01.10.2014, 08:30 – 10:00 - room Geneva

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