Emerging outcome measures for nutrition trials in the critically ill

Danielle E Bear, David Griffith, Zudin Puthucheary

Research output: Contribution to journalArticlepeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)417-422
Number of pages6
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Volume21
Issue number6
Early online date24 Aug 2018
DOIs
Publication statusPublished - 1 Nov 2018

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