Critical illness Other
Conditions
Interventions
Biological samples will be collected from patients and controls after informed consent in order to perform the detailed studies as described. This includes the sampling of blood, mouth mucosa, hair, u
Sponsors
KU Leuven
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Patients: All adult/senior patients at the surgical and medical intensive care units are eligible 2. Controls: A control group of volunteers who have not been critically ill, but have similar comorbidities as the critically ill patients will be recruited to match demographically with the patient group
Exclusion criteria
Exclusion criteria: 1. Patients: 1.1. General: 1.1.1. Age younger than 18 years 1.1.2. Readmission to ICU (unless within 48 hrs) 1.1.3. Declined participation 1.1.4. DNR code 1.1.5. Patients with HIV 1.1.6. Chronic systemic treatment with glucocorticoids prior to ICU admission (added 12/09/2018: patients who did receive chronic systemic treatment with glucocorticoids prior to ICU admission will be recruited separately to allow investigation of the impact of prior chronic systemic glucocorticoid treatment) 1.2. Blood sampling: absence of arterial line 1.3. Mouth mucosa sampling: normal mouth mucosa not accessible (e.g. post-tumor resection) 1.4. Neuromuscular evaluation: 1.4.1. General: 1.4.1.1. Patients with neuromuscular disorders identified prior to ICU admission / unable to walk without assistance (wheelchair, walking stick, arm support) prior to ICU admission 1.4.1.2. Patients with a neuromuscular disorder as reason for ICU admission 1.4.2. Muscle biopsy: increased bleeding risk 1.4.2.1. Platelet count below 50000/mm3 and/or PT below 40% 1.4.2.2. Known coagulation disorders 1.4.2.3. Use of anti-coagulation or thrombolytic agents 1.4.3. Muscle force by MRC sum score: 1.4.3.1. No muscle biopsy 1.4.3.2. Patient not awake/cooperative (*) 1.4.4. Hand grip strength 1.4.4.1. No muscle biopsy 1.4.4.2. Patients not awake/cooperative (*) 1.4.4.4. Medical Research Council (MRC) score for forearm flexion or wrist extension below 3 1.4.5. Electromyography / nerve conduction studies / direct muscle stimulation 1.4.5.1. No muscle biopsy (*) patients who give a biopsy but are not awake/cooperative at the time of sampling will be screened for awakening/cooperation up until two days later for MRC sum scoring and hand grip strength 1.5. Fat biopsy: increased bleeding risk: 1.5.1. Platelet count below 50000/mm3 and/or PT below 40% 1.5.2. Known coagulation disorders 1.5.3. Use of anti-coagulation or thrombolytic agents 2. Controls: 2.1. General 2.1.1. Age younger than 18 years 2.1.2. Previous ICU stay (except coronary care unit stay) 2.2. Blood sampling: known severe coagulation disorders (e.g. hemophilia) 2.3. Mouth mucosa sampling: normal mouth mucosa not accessible (e.g. post-tumor resection) 2.4. Muscle and fat biopsy: 2.4.1. Controls with acute or chronic neuromuscular disorders or unable to walk without assistance (wheelchair, walking stick, arm support) will be excluded for muscle biopsy 2.4.2. Increased risk of bleeding: 2.4.2.1. Known coagulation disorders 2.4.2.2. Use of anti-coagulation 2.5. Muscle force / electrophysiology / direct muscle stimulation: no muscle biopsy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To study in detail, in preset time windows of ICU stay, the time course of the epigenetic, metabolic and endocrine alterations that develop in response to critical illness and to unravel potential underlying processes involved in these changes | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Reanalysis of the time course of the alterations described in the primary objective 2. Within-subjects longitudinal analysis of changes for those patients who participate multiple times | — |
Countries
Belgium
Contacts
Public ContactGreet Van den Berghe
Outcome results
None listed