The role of objective measurement of skeletal muscle function in the pre-operative patient

Zeiderman, M.R.; McMahon, M. J.

doi:10.1016/0261-5614(89)90066-6

Cited by 30 publications

(5 citation statements)

References 16 publications

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“…One such example is adductor pollicis muscle function, which can be measured in an unconscious patient by electrically stimulating the nerve and measuring the strength of thumb contraction . Muscle function measured in this way has been shown to reflect early changes in nutrition, but it requires specialized equipment and is uncomfortable and technically difficult with low specificity . In addition, it has several confounders among the critically ill, such as tissue electrical conductivity (affected by skin moisture that changes constantly and by subcutaneous fat that may be decreasing over time), tendon contractility (which may increase in a bedbound person), and muscle mass (which will usually be catabolized over time in critical illness).…”

Section: Discussionmentioning

confidence: 99%

“…43 Muscle function measured in this way has been shown to reflect early changes in nutrition, 43,44 but it requires specialized equipment and is uncomfortable and technically difficult 45 with low specificity. 46 In addition, it has several confounders among the critically ill, such as tissue electrical conductivity (affected by skin moisture that changes constantly and by subcutaneous fat that may be decreasing over time), tendon contractility (which may increase in a bedbound person), and muscle mass (which will usually be catabolized over time in critical illness). Another example is bioelectrical impedance, which has been suggested to indicate early changes in nutrition by measuring body cell mass.…”

Section: Indicators With Low Feasibility And/or Low Availabilitymentioning

confidence: 99%

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Monitoring Nutrition in Critical Illness: What Can We Use?

Ferrie

Tsang

2017

Nut in Clin Prac

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Background: Nutrition monitoring in the context of critical care presents unique challenges. Traditionally used anthropometric and biochemical markers may be difficult to obtain or confounded by factors such as fluid status and the inflammatory response. A previous survey identified 15 parameters in common use, all of which have confounding influences during critical illness. Materials and Methods: A literature search was conducted to assess current use of commonly used nutrition-monitoring parameters and to explore other possible methods that might be more useful. More than 1000 journal articles were reviewed to identify indicators of nutrition status or nutrition progress that have been used in ICU studies. The most recent 200 articles were examined to quantify the number of occurrences for each indicator. Each parameter was rated for availability and feasibility in the ICU. Results: There were 53 parameters found, including the 15 already identified as commonly used; 27 were used in ࣙ3 recent studies. Less-wellestablished nutrition indicators with potential for use in the ICU (moderate or high feasibility and availability) included ultrasound measurement of arm or leg muscle thickness, fatigue scoring with the Chalder scale, urinary creatinine assay, and serum insulin-like growth factor 1 level. None of these was among the commonly used indicators in recent studies. Conclusion: This study identifies commonly used nutrition-monitoring parameters and discusses their feasibility and availability in the critical care setting. Further investigation of nutrition indicators in ICU is needed, ideally as part of a randomized trial to reduce the effect of the many possible confounding factors. (Nutr Clin Pract. 2018;33:133-146)

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Section: Discussionmentioning

confidence: 99%

Section: Indicators With Low Feasibility And/or Low Availabilitymentioning

confidence: 99%

Monitoring Nutrition in Critical Illness: What Can We Use?

Ferrie

Tsang

2017

Nut in Clin Prac

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“…LBM, including tissues involved in immune defense mechanisms, accounts for approximately half of the weight loss associated with the inflammatory responses in hospitalized patients and increases risk of infection and delayed wound healing 7 . The loss of lean body muscle is exacerbated in conditions in the ICU such as sepsis, trauma, surgical recovery, and cancer, where stressed states are fuelled, in part, by catabolism of amino acids from muscle protein breakdown and reduced in the presence of insulin resistance 5 , 22 , 23 . Elderly patients experience hyperglycemia related to diabetes and stress, as well as ARDS, in much higher proportions than do younger patients, which, in turn, are risk factors for CPNM 2 .…”

Section: Loss Of Lean Body Mass In Elderly Patientsmentioning

confidence: 99%

Elderly Persons With ICU‐Acquired Weakness

Rahman

Wilund

Fitschen

et al. 2013

J Parenter Enteral Nutr

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Intensive care unit (ICU)-acquired weakness is common and characterized by muscle loss, weakness, and paralysis. It is associated with poor short-term outcomes, including increased mortality, but the consequences of reduced long-term outcomes, including decreased physical function and quality of life, can be just as devastating. ICU-acquired weakness is particularly relevant to elderly patients who are increasingly consuming ICU resources and are at increased risk for ICU-acquired weakness and complications, including mortality. Elderly patients often enter critical illness with reduced muscle mass and function and are also at increased risk for accelerated disuse atrophy with acute illness. Increasingly, intensivists and researchers are focusing on strategies and therapies aimed at improving long-term neuromuscular function. β-Hydroxy-β-methylbutyrate (HMB), an ergogenic supplement, has shown efficacy in elderly patients and certain clinical populations in counteracting muscle loss. The present review discusses ICU-acquired weakness, as well as the unique physiology of muscle loss and skeletal muscle function in elderly patients, and then summarizes the evidence for HMB in elderly patients and in clinical populations. We subsequently postulate on the potential role and strategies in studying HMB in elderly ICU patients to improve muscle mass and function.

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“…Grip strength can be measured using a dynamometer, but is demanding on the patient; with repeated use, improved technique can lead to an apparent increase in function 35. Electromyography, measuring muscle contraction in response to a standardised stimulus, is more objective but more invasive36; several studies have suggested that it better predicts malnutrition-related complications than other techniques of nutritional assessment 37 38…”

Section: Techniques In Nutritional Assessmentmentioning

confidence: 99%

Nutritional assessment: its role in the provision of nutritional support

Marshall

2008

J Clin Pathol

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Generalised undernutrition is common in hospital patients and in the community. It is frequently unrecognised and is associated with a range of adverse consequences that contribute to increased morbidity and mortality. The National Institute for Health and Clinical Excellence recommends that all individuals engaging with healthcare or admitted to residential homes in the community should be screened for undernutrition. Laboratory investigations have little place in the diagnosis of undernutrition: this is primarily a clinical process. In particular, the measurement of serum albumin concentration, though widely promulgated in the past as an index of nutritional status, is worthless for this purpose. Laboratory investigations are, however, of importance: to diagnose specific nutritional deficiencies (eg, of trace elements) and to monitor the provision of nutritional support, to detect metabolic complications and to assess its adequacy (for which the measurement of serum prealbumin concentrations, particularly in conjunction with measurements of C-reactive protein, may be of value).

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The role of objective measurement of skeletal muscle function in the pre-operative patient

Cited by 30 publications

References 16 publications

Monitoring Nutrition in Critical Illness: What Can We Use?

Monitoring Nutrition in Critical Illness: What Can We Use?

Elderly Persons With ICU‐Acquired Weakness

Nutritional assessment: its role in the provision of nutritional support

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