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| Name | Class |
|---|---|
| Jessa Hospital | OTHER |
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Muscle wasting occurs rapidly in critically ill patients and impacts both short and long term outcomes. Altered protein metabolism drives muscle loss in ICU patients, with muscle protein breakdown exceeding muscle protein synthesis (MPS). Interventions aimed at attenuating muscle loss by stimulating MPS rates are hampered by a lack of knowledge on altered muscle protein turnover rates during critical illness. Only a few studies have specifically assessed muscle protein synthesis by using contemporary intravenous stable isotope infusions, which allows the assessment of MPS over a short (<9 hours) period of time. Results from such acute studies can be difficult to extend or translate into long-term clinical practice and outcomes. Oral deuterated water (2H2O) dosing provides an alternative method that can be utilized to extend the measurement of muscle protein synthesis over a period of several days or weeks. It could therefore provide a valuable tool to study muscle protein synthesis during ICU admission and the impact of different anabolic interventions. Although multiple studies using the deuterated water methodology have been performed in both healthy volunteers and patients, it has not yet been performed in critically ill patients.
In this prospective study the investigators aim to assess fractional rates of muscle protein synthesis over a period of (maximal) 7 days in critically ill patients admitted to the intensive care unit. Secondly, the investigators aim to assess mechanisms of acute muscle wasting on an microscopic, ultrastructural and molecular level. Furthermore, the investigators aim to investigate to what extent muscle fibre size is recovered 3 months after ICU discharge.
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| Measure | Description | Time Frame |
|---|---|---|
| muscle protein synthesis rate (%/h) | obtained by using deuterated water, muscle biopsy sampling and blood sampling | 7 days of stay at the intensive care unit |
| Measure | Description | Time Frame |
|---|---|---|
| skeletal muscle fiber characteristics 1 | cross sectional area of muscle fibers | 7 days of stay at the intensive care unit |
| skeletal muscle fiber characteristics 2 | amount and distribution of muscle fibers (distribution will be calculated as: amount of type X / total amount of fibres) |
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Inclusion Criteria:
Exclusion Criteria:
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In total 20 patients admitted to the ICU will be included.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Michelle Weijzen, Dr. | Contact | 003211268706 | michelle.weijzen@uhasselt.be | |
| Frank Vandenabeele, Prof. | Contact | frank.vandenabeele@uhasselt.be |
| Name | Affiliation | Role |
|---|---|---|
| Frank Vandenabeele, Prof. | Hasselt University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jessa Hospital | Recruiting | Hasselt | Limburg | 3500 | Belgium |
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| D009133 | Muscular Atrophy |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020879 | Neuromuscular Manifestations |
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| 7 days of stay at the intensive care unit |
| mRNA expression in skeletal muscle tissue 1 | mRNA expression in skeletal muscle tissue of MAFBx (atrophy marker) | 7 days of stay at the intensive care unit |
| mRNA expression in skeletal muscle tissue 2 | mRNA expression in skeletal muscle tissue of MurF1 (atrophy marker) | 7 days of stay at the intensive care unit |
| mRNA expression in skeletal muscle tissue 3 | mRNA expression in skeletal muscle tissue of FOXO (atrophy marker) | 7 days of stay at the intensive care unit |
| patient characteristic- age | age in years | 7 days of stay at the intensive care unit |
| patient characteristic- body weight | body weight in kg | 7 days of stay at the intensive care unit |
| patient characteristic- height | height in m | 7 days of stay at the intensive care unit |
| patient characteristic- sex | male or female | 7 days of stay at the intensive care unit |
| patient characteristics (medical1) | mechanical ventilation (duration in days) | 7 days of stay at the intensive care unit |
| patient characteristics (medical2) | comorbidities (list of comorbidities) | 7 days of stay at the intensive care unit |
| patient characteristics (medical3) | reason hospital admission | 7 days of stay at the intensive care unit |
| patient characteristic- APACHE score II | APACHE II score = acute physiology score + age points + chronic health points. Minimum score = 0; maximum score = 71. | 7 days of stay at the intensive care unit |
| patient characteristic- food intake | food intake (energy in kcal and protein intake in g/kg/d) | 7 days of stay at the intensive care unit |
| patient characteristic- LOS | Length of stay ICU and hospital (in days) | Stay at the intensive care unit and Hospital (up to 1 year) |
| muscle volume | 3d ultrasound assessed at follow up visit | 3 months post-hospital discharge |
| habitual food | Assessed using questionnaires at follow up visit (higher score means better intake) | 3 months post-hospital discharge |
| habitual activity | Assessed using questionnaires at follow up visit (higher score means better intake) | 3 months post-hospital discharge |
| muscle hand grip strength | hand grip strength using the JAMAR dynamometer in kg | 3 months post-hospital discharge |
| leg muscle strength | 1RM upper leg at follow up visit | 3 months post-hospital discharge |
| Functional capacity 1 | SPPB at follow up visit (short physical performance battery) | 3 months post-hospital discharge |
| Functional capacity 2 | 6min walking test at follow up visit | 3 months post-hospital discharge |
| Quality of life questionnaire | SF-36 at follow up visit (Short Form Health Survey 36 items) range score between 0-100, lower score represents great health related problems | 3 months post-hospital discharge |
| Quality of life questionnaires | Euro-QoL-5D-5-level at follow up visit (Euro quality of life 5 Dimension 5 level) Answers can be converted into EQ-5D index, an utility scores anchored at 0 for death and 1 for perfect health | 3 months post-hospital discharge |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D001284 | Atrophy |
| D020763 | Pathological Conditions, Anatomical |
| D012816 | Signs and Symptoms |