Intensive Care Unit Acquired Paresis, Muscle Wasting
Conditions
Keywords
ICUAP, Critical illness, Muscle wasting, ICU
Brief summary
The primary hypothesis for this study is that Myostatin and FHL-1 are important in the development of ICUAP and that changes in activity levels of muscle will modify the levels of expression and activity of these proteins.
Detailed description
ICUAP is an increasingly recognised clinical problem associated with significant morbidity and mortality. However the pathogenesis of the diseae is poorly understood and as yet no treatment exists. We believe that both myostatin and FHL-1 will be important in the development of this disease. This is based recent research and that both these proteins are likely to be regulated by sepsis and immobility (two major risk factors for ICUAP. There is evidence from invitro work that the two are likely to interact. We have designed an interventional trial to investigate the above hypothesis. Patients admitted to ICU and at risk of developing muscle wasting will be selected and receive electrical muscle stimulation of the quadriceps muscle for 1 week. Physiological measurements of peripheral and respiratory muscle strength and quadriceps size will be made pre and post intervention. And muscle biopsies, blood and urine collected from both legs pre and post intervention. The relevant molecular pathways can then be examined.
Interventions
OTHERActive muscle stimulation
Neuromuscular Electrical stimulation will be applied to one leg (randomly assigned).
Sponsors
Imperial College London
Medical Research Council
Royal Brompton & Harefield NHS Foundation Trust
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* High risk patients admitted to AICU.
Exclusion criteria
* Pre existing neuromuscular disease.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in muscle myostatin and FHL-1 | 1 week |
Secondary
| Measure | Time frame |
|---|---|
| Change in quadriceps strength | 1 week |
| Change in blood myostatin, miRNA and other markers of muscle breakdown | 1 week |
| Change in quadriceps cross sectional area | 1 week |
| Change in muscle breakdown and synthesis pathways as a factor of amount of muscle stimulation received. | 1 week |
| Change in muscle phenotype and change in cross sectional area for individual fiber types | 1 week |
| Changes in muscle protein synthesis and breakdown pathways as measured in the muscle biopsy samples. | 1 week |
Countries
United Kingdom
Outcome results
None listed