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More and more patients survive a critical illness requiring admission to the intensive care unit, but they may be left with sequelae that are independent of the initial pathology. From a physical standpoint, the most visible complication is intensive care unit-acquired muscle weakness. A major factor in the development and persistence of muscle dysfunction appears to be the inflammatory response and the neuroendocrine stress response triggered by the initial critical insult. Persistence of inflammation beyond ICU discharge has been demonstrated in several studies. In response to inflammation, there is also increased oxidative stress associated with mitochondrial dysfunction.
The objectives of the present study are therefore:
to determine whether the broad inflammatory and metabolic profile of patients who have survived an ICU stay can predict the trajectory of muscle performance over the three months following ICU discharge; to compare this profile and muscle performance with those of non-critically ill surgical patients who have undergone a standardized inflammatory stress of lower intensity than that associated with critical illness; to investigate mitochondrial function in skeletal striated muscle after ICU stay, in light of the inflammatory and metabolic profile; to assess whether abnormalities in mitochondrial function also affect tissues other than skeletal muscle, in particular circulating blood mononuclear cells.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ICU patients | Experimental | Lab and clinical investigations to characterize the metabolic and muscle profile |
|
| Surgical patients | Active Comparator | Lab and clinical investigations to characterize the metabolic and muscle profile |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Inflammation markers | Diagnostic Test | measurement of CRP, cytokines, MPO, oxidative stress during the first 7 days after ICU admission, between 1 and 7 days after ICU discharge and 3 months after ICU discharge (or the day after surgery and 3 months after hospital discharge) |
| Measure | Description | Time Frame |
|---|---|---|
| Quadriceps strength | Quadriceps strength in Newton, measured using a handheld dynamometer (MicroFet) | between 1 and 7 days after ICU discharge and 3 months after ICU discharge in the critically ill patients, or the day after the surgery and 3 months after the surgery in surgical patients |
| Handgrip strength | Hangrip strength in kg, measured young an handheld dynamometer (Jamar) | between 1 and 7 days after ICU discharge and 3 months after ICU discharge in the critically ill patients, or the day after the surgery and 3 months after the surgery in surgical patients |
| Muscle mass | Quadriceps muscle thickness assessed by ultrasound | between 1 and 7 days after ICU discharge and 3 months after ICU discharge in the critically ill patients, or the day after the surgery and 3 months after the surgery in surgical patients |
| Muscle mass | Muscle mass assessed using bioelectrical impedance analysis | between 1 and 7 days after ICU discharge and 3 months after ICU discharge in the critically ill patients, or the day after the surgery and 3 months after the surgery in surgical patients |
| Muscle mitochondrial function | Oxygraphy performed on a muscle sample | between 1 and 7 days after ICU discharge and 3 months after ICU discharge in the critically ill patients, or perioperatively and 3 months after the surgery in surgical patients |
| Muscle function | Transcriptomic analysis in muscle sample (muscle biopsy) | between 1 and 7 days after ICU discharge and 3 months after ICU discharge in the critically ill patients, or perioperatively and 3 months after the surgery in surgical patients |
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| Measure | Description | Time Frame |
|---|---|---|
| Health-related Quality of life | EQ-5D-3L questionnaire (3-level version of the EuroQOL questionnaire, including EQ-5D descriptive system with higher score indicating worst quality of life and the EQ visual analogue scale ranging from 0 to 100, with higher score indicating best quality of life) | 3 months after ICU discharge in the critically ill patients, or 3 months after the surgery in surgical patients |
Inclusion Criteria
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Sart Tilman | Recruiting | Liège | 4000 | Belgium |
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D001823 | Body Composition |
| ID | Term |
|---|---|
| D001669 | Biochemical Phenomena |
| D055598 | Chemical Phenomena |
| D008660 | Metabolism |
| D001824 | Body Constitution |
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| Blood nucleosomes | Diagnostic Test | measurement of blood nucleosomes between 1 and 7 days after ICU discharge and 3 months after ICU discharge (or the day after surgery and 3 months after hospital discharge) |
|
| Erythrocyte membrane fatty acid content | Diagnostic Test | assessment of Erythrocyte membrane fatty acid content between 1 and 7 days after ICU discharge and 3 months after ICU discharge (or the day after surgery and 3 months after hospital discharge) |
|
| measurement of myokines | Diagnostic Test | measurement of myokines between 1 and 7 days after ICU discharge and 3 months after ICU discharge (or the day after surgery and 3 months after hospital discharge) |
|
| Resting energy expendure | Diagnostic Test | assessment of REE by indirect caloriometry during the first 7 days after ICU admission, between 1 and 7 days after ICU discharge and 3 months after ICU discharge (or the day after surgery and 3 months after hospital discharge) |
|
| body composition | Diagnostic Test | assessment of body composition by BIA during the first 7 days after ICU admission, between 1 and 7 days after ICU discharge and 3 months after ICU discharge (or the day after surgery and 3 months after hospital discharge) |
|
| Omics | Diagnostic Test | Blood metabolic, lipidomic, proteomic study during the first 7 days after ICU admission (or the day after surgery) |
|
| Monocyte profile | Diagnostic Test | Blood leukocyte and monocyte profiles and transcriptomic analysis between 1 and 7 days after ICU discharge and 3 months after ICU discharge (or the day after surgery and 3 months after hospital discharge) |
|
| Physical function | 2-minute walking test | between 1 and 7 days after ICU discharge and 3 months after ICU discharge (or the day after surgery and 3 months after hospital discharge) |
| Autonomy for ADL | Barthel index, ranging from 0 to 100, with higher score indicating full independency for activities of daily living | 3 months after ICU discharge in the critically ill patients, or 3 months after the surgery in surgical patients |
| Health-related quality of life | SARQOL questionnaire (Sarcopenia and Quality Of Life questionnaire) - short form, ranging from 0 to 100, with higher score indicating best quality of life | 3 months after ICU discharge in the critically ill patients, or 3 months after the surgery in surgical patients |
| D010829 |
| Physiological Phenomena |