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ID 114743
Author
Takashima, Takuya Tokushima University
Keywords
muscle atrophy
diaphragm
ultrasound
physical therapy
electrical muscular stimulation
Content Type
Journal Article
Description
Critically ill patients exhibit prominent muscle atrophy, which occurs rapidly after ICU admission and leads to poor clinical outcomes. The extent of atrophy differs among muscles as follows: upper limb: 0.7%–2.4% per day, lower limb: 1.2%–3.0% per day, and diaphragm 1.1%–10.9% per day. This atrophy is caused by numerous risk factors such as inflammation, immobilization, nutrition, hyperglycemia, medication, and mechanical ventilation. Muscle atrophy should be monitored noninvasively by ultrasound at the bedside. Ultrasound can assess muscle mass in most patients, although physical assessment is limited to almost half of all critically ill patients due to impaired consciousness. Important strategies to prevent muscle atrophy are physical therapy and electrical muscular stimulation. Electrical muscular stimulation is especially effective for patients with limited physical therapy. Regarding diaphragm atrophy, mechanical ventilation should be adjusted to maintain spontaneous breathing and titrate inspiratory pressure. However, the sufficient timing and amount of nutritional intervention remain unclear. Further investigation is necessary to prevent muscle atrophy and improve long-term outcomes.
Journal Title
The Journal of Medical Investigation
ISSN
13496867
13431420
NCID
AA12022913
AA11166929
Publisher
Tokushima University Faculty of Medicine
Volume
67
Issue
1-2
Start Page
1
End Page
10
Sort Key
1
Published Date
2020-02
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
University Hospital