TY - JOUR
T1 - Muscle size, strength, and physical function in response to augmented calorie delivery
T2 - A TARGET sub-study
AU - The TARGET Investigators for the Australia and New Zealand Intensive Care Society Clinical Trials Group
AU - Chapple, Lee anne S.
AU - Summers, Matthew J.
AU - Weinel, Luke M.
AU - Lange, Kylie
AU - Yang, Woo Han
AU - Deane, Adam M.
AU - Chapman, Marianne J.
N1 - Publisher Copyright:
© 2022
PY - 2022/12
Y1 - 2022/12
N2 - Purpose: Augmented calories may attenuate muscle loss experienced in critical illness. This exploratory sub-study assessed the effect of augmented calorie delivery on muscle mass, strength, and function. Materials and methods: Patients in The Augmented versus Routine approach to Giving Energy Trial (TARGET) randomised to 1.5 kcal/ml or 1.0 kcal/ml enteral formulae at a single-centre were included. Ultrasound-derived muscle layer thickness (MLT) at quadriceps, forearm and mid-upper arm, and handgrip strength, were measured weekly from baseline to hospital discharge, and 3- and 6-months. Physical function was assessed at 3- and 6-months using the ‘get up and go’ and 6-min walk tests. Data are mean ± SD. Results: Eighty patients were recruited (1.5 kcal: n = 38, 58 ± 14y, 60%M, APACHE II 20 ± 7; 1.0 kcal: n = 42, 54 ± 18y, 66%M, APACHE II 22 ± 10). The 1.5 kcal/ml group received more calories with no difference in quadriceps MLT at any timepoint including ICU discharge (primary outcome) (2.90 ± 1.27 vs 2.39 ± 1.06 cm; P = 0.141). Relationships were similar for all MLT measures, handgrip strength, and 6-min walk test. Patients in the 1.5 kcal/ml group had improved ‘get up and go’ test at 3-months (6.66 ± 1.33 vs. 9.11 ± 2.94 s; P = 0.014). Conclusion: Augmented calorie delivery may not attenuate muscle loss or recovery of strength or function 6-months post-ICU, but this requires exploration in a larger trial.
AB - Purpose: Augmented calories may attenuate muscle loss experienced in critical illness. This exploratory sub-study assessed the effect of augmented calorie delivery on muscle mass, strength, and function. Materials and methods: Patients in The Augmented versus Routine approach to Giving Energy Trial (TARGET) randomised to 1.5 kcal/ml or 1.0 kcal/ml enteral formulae at a single-centre were included. Ultrasound-derived muscle layer thickness (MLT) at quadriceps, forearm and mid-upper arm, and handgrip strength, were measured weekly from baseline to hospital discharge, and 3- and 6-months. Physical function was assessed at 3- and 6-months using the ‘get up and go’ and 6-min walk tests. Data are mean ± SD. Results: Eighty patients were recruited (1.5 kcal: n = 38, 58 ± 14y, 60%M, APACHE II 20 ± 7; 1.0 kcal: n = 42, 54 ± 18y, 66%M, APACHE II 22 ± 10). The 1.5 kcal/ml group received more calories with no difference in quadriceps MLT at any timepoint including ICU discharge (primary outcome) (2.90 ± 1.27 vs 2.39 ± 1.06 cm; P = 0.141). Relationships were similar for all MLT measures, handgrip strength, and 6-min walk test. Patients in the 1.5 kcal/ml group had improved ‘get up and go’ test at 3-months (6.66 ± 1.33 vs. 9.11 ± 2.94 s; P = 0.014). Conclusion: Augmented calorie delivery may not attenuate muscle loss or recovery of strength or function 6-months post-ICU, but this requires exploration in a larger trial.
KW - Calories
KW - Critical illness
KW - Enteral nutrition
KW - Functional recovery
KW - Intensive care
KW - Muscle mass
UR - http://www.scopus.com/inward/record.url?scp=85137308360&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2022.154140
DO - 10.1016/j.jcrc.2022.154140
M3 - Article
C2 - 36058058
AN - SCOPUS:85137308360
SN - 0883-9441
VL - 72
JO - Journal of Critical Care
JF - Journal of Critical Care
M1 - 154140
ER -