Esther Dupont-Versteegden
The overarching goal of the proposed study is to determine the trajectories of physical recovery and cellular markers involved with the underlying failure to recover muscle after critical illness, while exploring which characteristics are associated with sustained physical disability. This proposal will examine muscle pathophysiology carefully aligned with physical function outcomes in order to longitudinally assess the recovery, or failed recovery, of muscle function in participants after critical illness: 1. to examine the recovery of muscle and physical function in ICU survivors through longitudinal assessments 2. to investigate the underlying cellular markers and mechanisms of muscle recovery in ICU survivors 3. to determine which cellular markers contribute to physical disability in ICU survivors up to 1 year after hospital admission
Patients surviving critical illness develop significant impairments in skeletal muscle, commonly referred to as ICU-acquired weakness (ICUAW)\[8-10\]. It is estimated that up to 70-80% of patients admitted to ICU will develop some degree of neuromuscular dysfunction, weakness, myopathy or atrophy \[11,12\]. ICUAW encompasses muscle impairments that develop as a direct result of admission for critical illness\[13\] and is an independent predictor of mortality and long-term functional impairments\[14-19\]. Interventions to mitigate muscle deficits and improve physical function are a critical are…
Inclusion Criteria: * adult (\>18 y/o) * admission for sepsis or acute respiratory failure with at least 72 hour stay in ICU Exclusion Criteria: * patients who were not ambulatory prior to ICU admission * experienced \>2 ICU admissions in the past year (chronic or recurrent critical illness due to the same or different reason * patients not expected to survive \~6months after admission * acute or chronic neurologic condition * acute or chronic orthopedic condition preventing strength/functional testing * morbid obesity \>50 kg/m2 due to distortion of muscle ultrasonography