Abstract / Description of output
Purpose of review: Mortality has long been the gold-standard outcome measure
for intensive care clinical trials. However as the critical care community begins to
understand and accept that survivorship is associated with functional disability
and a health and socioeconomic burden, the clinical and research focus has
begun to shift towards long term physical function
Recent findings: To use mortality as a primary outcome measure, one would
either have to choose an improbable effect (e.g. a difference of 5-10% in
mortality as a result of a single intervention) or recruit a larger number of
patients; the latter being unfeasible for most critical care trials.
Outcome measures will need to match interventions. As an example, amino acids,
or intermittent feeding can stimulate muscle protein synthesis, and so
prevention of muscle wasting may seem an appropriate outcome measure when
assessing the effectiveness of these interventions. Testing the effectiveness of
these interventions requires the development of novel outcome measures that
are targeted and acceptable to patients. We describe advancements in DXA
scanning, bio-impedence analysis, MRI, and muscle ultrasound in this patient
group that are beginning to address this development need.
Summary: New approaches to outcome assessment are beginning to appear in
post-ICU research which promise to improve our understanding of nutrition and
exercise interventions on skeletal muscle structure, composition, and function,
without causing undue suffering to the patient.
for intensive care clinical trials. However as the critical care community begins to
understand and accept that survivorship is associated with functional disability
and a health and socioeconomic burden, the clinical and research focus has
begun to shift towards long term physical function
Recent findings: To use mortality as a primary outcome measure, one would
either have to choose an improbable effect (e.g. a difference of 5-10% in
mortality as a result of a single intervention) or recruit a larger number of
patients; the latter being unfeasible for most critical care trials.
Outcome measures will need to match interventions. As an example, amino acids,
or intermittent feeding can stimulate muscle protein synthesis, and so
prevention of muscle wasting may seem an appropriate outcome measure when
assessing the effectiveness of these interventions. Testing the effectiveness of
these interventions requires the development of novel outcome measures that
are targeted and acceptable to patients. We describe advancements in DXA
scanning, bio-impedence analysis, MRI, and muscle ultrasound in this patient
group that are beginning to address this development need.
Summary: New approaches to outcome assessment are beginning to appear in
post-ICU research which promise to improve our understanding of nutrition and
exercise interventions on skeletal muscle structure, composition, and function,
without causing undue suffering to the patient.
Original language | English |
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Pages (from-to) | 417-422 |
Number of pages | 6 |
Journal | Current Opinion in Clinical Nutrition and Metabolic Care |
Volume | 21 |
Issue number | 6 |
Early online date | 24 Aug 2018 |
DOIs | |
Publication status | Published - 1 Nov 2018 |