22 April 2016

Winning the war against ICU-acquired weakness new innovations in nutrition and exercise physiology.

Posted in Indirect Calorimetry, Scientific

indirect calorimetry

A new study published in the Critical Care Journal introduced a new protocol “RISEN"–Recovery from ICU via Surveillance, Exercise, and Nutrition" for post-ICU survivors

The RISEN procotol represents a combination of modern performance-enhancing nutrition, anticatabolic/anabolic interventions, and muscle/exercise testing in order to begin to create more “survivors” and fewer victims post ICU care.

The RISEN experimental protocol (Table 1) proposes that "in order to optimize post-ICU quality of live, we must first evaluate the nutritional needs of our patients via accurate metabolic cart caloric need measurements (so as to prevent underfeeding and overfeeding). The era of “guessing” at caloric needs with equations must end–we would not guess at the blood pressure while administering vasopressors, so why should we guess at caloric needs when the epidemic of obesity and the increasingly older ICU patient have proven convincingly that we are not good guessers".

In addition, promoting early mobility improves post-ICU quality of life. "Modern exercise physiology testing and monitoring as optimized and routinely performed by expert exercise physiologists allows for the accurate determination of mitochondrial function and substrate utilization by muscle at increasing workloads (see Figure 6). This allows for an ideal and individualized exercise intensity (i.e., heart rate) and workload to be targeted to increase mitochondrial function and performance efficiency in the forms of increased lactate clearance capacity and capacity to oxidize fat in the muscle (Figure 6a), which is key for performance".


The article details are the following:

- Title: "Winning the war against ICU-acquired weakness new innovations in nutrition and exercise physiology"
- Authors: Paul E Wischmeyer and Inigo San-Millan - Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO USA
- Published in
: Crit Care. 2015; 19(Suppl 3): S6.

The full study can be downloaded at the following link: click here