Muscle Wasting and Early Mobilization in Acute Respiratory Distress Syndrome

Walsh, Christopher J.; Batt, Jane; Herridge, Margaret S.; Santos, Claudia C. dos

doi:10.1016/j.ccm.2014.08.016

Cited by 27 publications

(18 citation statements)

References 122 publications

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“…Early mobilization of critically ill ARDS patients has been shown to attenuate skeletal muscle wasting [39] and likely reduces inflammation [40] as well. Although elderly patients are at higher risk for death due to sepsis during ARDS, whether low-intensity AE (AE) protects against PS-mediated inflammation in the elderly has not been studied to date.…”

Section: Discussionmentioning

confidence: 99%

Aerobic Exercise Protects from Pseudomonas aeruginosa-Induced Pneumonia in Elderly Mice

et al. 2018

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Background: Pseudomonas aeruginosa (PS) infection results in severe morbidity and mortality, especially in immune-deficient populations. Aerobic exercise (AE) modulates the immune system, but its effects on the outcomes of pulmonary PS infection in elderly mice are unknown. Methods: BALB/c mice (24 weeks old) were randomized to sedentary, exercise (EX), PS, and PS + EX groups for the acute experimental setting, and PS and PS + EX groups for the chronic setting. Low-intensity AE was performed for 5 weeks, 60 min/day; 24 h after the final AE session, mice were inoculated with 5 × 10⁴ colony-forming units (CFU) of PS, and 24 h and 14 days after PS inoculation, mice were studied. Results: AE inhibited PS colonization (p < 0.001) and lung inflammation (total cells, neutrophils, lymphocytes [p < 0.01] in bronchoalveolar lavage [BAL]), with significant differences in BAL levels of IL-1β (p < 0.001), IL-6 (p < 0.01), CXCL1 (p < 0.001), and TNF-α (p < 0.001), as well as parenchymal neutrophils (p < 0.001). AE increased BAL levels of IL-10 and parenchymal (p < 0.001) and epithelial (p < 0.001) IL-10 expression, while epithelial (p < 0.001) and parenchymal (p < 0.001) NF-κB expression was decreased. AE diminished pulmonary lipid peroxidation (p < 0.001) and increased glutathione peroxidase (p < 0.01). Pre-incubation of BEAS-2B with IL-10 inhibited PS-induced epithelial cell expression of TNF-α (p < 0.05), CD40 (p < 0.01), and dichlorodihydrofluorescein diacetate (p < 0.05). Conclusions: AE inhibits PS-induced lung inflammation and bacterial colonization in elderly mice, involving IL-10/NF-κB, and redox signaling.

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Section: Discussionmentioning

confidence: 99%

Aerobic Exercise Protects from Pseudomonas aeruginosa-Induced Pneumonia in Elderly Mice

et al. 2018

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“…29,30 Those who experience ICUAW as a result of prolonged bedrest, sedation, steroid use, or neuromuscular blockade during critical illness 31 tend to have increased functional dependence, increased health-related costs, and increased mortality for a year or more after surviving their initial critical illness. 32,33 These patients often continue to experience neuromuscular abnormalities up to 5 years following discharge. 34,35…”

Section: Physical Outcomesmentioning

confidence: 99%

Physical, Cognitive, and Psychological Disability Following Critical Illness: What Is the Risk?

Jutte

Erb

Jackson

2015

Semin Respir Crit Care Med

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Critical illnesses affect millions of individuals annually in the United States. As advances in patient care continue to improve, the number of survivors is rapidly growing. Critical illness survivors endure profoundly severe illnesses and live through often frightening experiences throughout the course of ICU hospitalization, resulting in a variety of "survivorship" challenges, expressed through a condition known as post-intensive care syndrome (PICS). Questions abound regarding the ideal protocols for ensuring the best physical, cognitive, and psychological outcomes for these survivors. Organizational change is likely to be a key factor, though the specific components have not yet been established. Throughout this article, we highlight some of the barriers and facilitators to enhancing patient care across the spectrum of critical care environments, while also highlighting the challenges inherent to studying a complex patient population. We address each of the areas potentially affected by critical illness and ICU hospitalization--physical, cognitive, and psychological functional domains--experienced by patients as well as their family caregivers.

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“…About 30-40% of patients with ARDS die, and most survivors often suffer multiple morbidities related to their prolonged critical illness (3,4). Muscle weakness is evident in up to 50% of ARDS survivors, in whom it is associated with prolonged lengths of stay in the intensive care unit and the development of the multipleorgan dysfunction syndrome (5)(6)(7). In patients who survive ARDS, muscle weakness results in substantial morbidity and longterm reductions in quality of life (8)(9)(10)(11).…”

mentioning

confidence: 99%

Influenza A Virus Infection Induces Muscle Wasting via IL-6 Regulation of the E3 Ubiquitin Ligase Atrogin-1

Radigan

Nicholson

Welch

et al. 2019

The Journal of Immunology

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Muscle dysfunction is common in patients with adult respiratory distress syndrome and is associated with morbidity that can persist for years after discharge. In a mouse model of severe influenza A pneumonia, we found the proinflammatory cytokine IL-6 was necessary for the development of muscle dysfunction. Treatment with a Food and Drug Administration-approved Ab antagonist to the IL-6R (tocilizumab) attenuated the severity of influenza A-induced muscle dysfunction. In cultured myotubes, IL-6 promoted muscle degradation via JAK/STAT, FOXO3a, and atrogin-1 upregulation. Consistent with these findings, atrogin-1 +/2 and atrogin-1 2/2 mice had attenuated muscle dysfunction following influenza infection. Our data suggest that inflammatory endocrine signals originating from the injured lung activate signaling pathways in the muscle that induce dysfunction. Inhibiting these pathways may limit morbidity in patients with influenza A pneumonia and adult respiratory distress syndrome.

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Muscle Wasting and Early Mobilization in Acute Respiratory Distress Syndrome

Cited by 27 publications

References 122 publications

Aerobic Exercise Protects from Pseudomonas aeruginosa-Induced Pneumonia in Elderly Mice

Aerobic Exercise Protects from Pseudomonas aeruginosa-Induced Pneumonia in Elderly Mice

Physical, Cognitive, and Psychological Disability Following Critical Illness: What Is the Risk?

Influenza A Virus Infection Induces Muscle Wasting via IL-6 Regulation of the E3 Ubiquitin Ligase Atrogin-1

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