Activin A level is associated with physical function in critically ill patients.

Humans Critical Illness Hand Strength Muscle Weakness Postural Balance Time and Motion Studies Intensive Care Units
Activins ICU-acquired weakness Mortality Muscle Sarcopenia Skeletal

Journal

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
ISSN: 1036-7314
Titre abrégé: Aust Crit Care
Pays: Australia
ID NLM: 9207852

Informations de publication

Date de publication:
09 2023
Historique:
received: 15 06 2021
revised: 24 10 2022
accepted: 31 10 2022
medline: 25 8 2023
pubmed: 15 12 2022
entrez: 14 12 2022
Statut: ppublish

Résumé

Activin A is a potent negative regulator of muscle mass elevated in critical illness. It is unclear whether muscle strength and physical function in critically ill humans are associated with elevated activin A levels. The objective of this study was to investigate the relationship between serum activin A levels, muscle strength, and physical function at discharge from the intensive care unit (ICU) and hospital. Thirty-six participants were recruited from two tertiary ICUs in Melbourne, Australia. Participants were included if they were mechanically ventilated for >48 h and expected to have a total ICU stay of >5 days. The primary outcome measure was the Six-Minute Walk Test distance at hospital discharge. Secondary outcome measures included handgrip strength, Medical Research Council Sum Score, Physical Function ICU Test Scored, Six-Minute Walk Test, and Timed Up and Go Test assessed throughout the hospital admission. Total serum activin A levels were measured daily in the ICU. High peak activin A was associated with worse Six-Minute Walk Test distance at hospital discharge (linear regression coefficient, 95% confidence interval, p-value: -91.3, -154.2 to -28.4, p = 0.007, respectively). Peak activin A concentration was not associated with the secondary outcome measures. Higher peak activin A may be associated with the functional decline of critically ill patients. Further research is indicated to examine its potential as a therapeutic target and a prospective predictor for muscle wasting in critical illness. ACTRN12615000047594.

Sections du résumé

BACKGROUND
Activin A is a potent negative regulator of muscle mass elevated in critical illness. It is unclear whether muscle strength and physical function in critically ill humans are associated with elevated activin A levels.
OBJECTIVES
The objective of this study was to investigate the relationship between serum activin A levels, muscle strength, and physical function at discharge from the intensive care unit (ICU) and hospital.
METHODS
Thirty-six participants were recruited from two tertiary ICUs in Melbourne, Australia. Participants were included if they were mechanically ventilated for >48 h and expected to have a total ICU stay of >5 days. The primary outcome measure was the Six-Minute Walk Test distance at hospital discharge. Secondary outcome measures included handgrip strength, Medical Research Council Sum Score, Physical Function ICU Test Scored, Six-Minute Walk Test, and Timed Up and Go Test assessed throughout the hospital admission. Total serum activin A levels were measured daily in the ICU.
RESULTS
High peak activin A was associated with worse Six-Minute Walk Test distance at hospital discharge (linear regression coefficient, 95% confidence interval, p-value: -91.3, -154.2 to -28.4, p = 0.007, respectively). Peak activin A concentration was not associated with the secondary outcome measures.
CONCLUSIONS
Higher peak activin A may be associated with the functional decline of critically ill patients. Further research is indicated to examine its potential as a therapeutic target and a prospective predictor for muscle wasting in critical illness.
STUDY REGISTRATION
ACTRN12615000047594.

Identifiants

DOI: 10.1016/j.aucc.2022.10.019 PMID: 36517331
pubmed: 36517331
pii: S1036-7314(22)00235-1
doi: 10.1016/j.aucc.2022.10.019
pii:
doi:

Substances chimiques

activin A 0

Types de publication

Journal Article

Langues

eng

Pagination

702-707

Informations de copyright

Copyright © 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Auteurs

Yi Tian Wang (YT)

School of Primary and Allied Health Care, Monash University, Melbourne, Australia; Department of Physiotherapy, Peninsula Health, Melbourne, Australia. Electronic address: mwang@phcn.vic.gov.au.

Craig A Harrison (CA)

Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Australia. Electronic address: craig.harrison@monash.edu.

Elizabeth H Skinner (EH)

Emergency and Trauma Centre, Alfred Health, Melbourne, Australia; Department of Physiotherapy, Western Health, Melbourne, Australia; Australian Institute of Musculoskeletal Science, The University of Melbourne, Melbourne, Australia. Electronic address: drlizzieskinner@gmail.com.

Kimberley J Haines (KJ)

Department of Physiotherapy, Western Health, Melbourne, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, Australia. Electronic address: kimberley.haines@wh.org.au.

Clare Holdsworth (C)

Department of Physiotherapy, Western Health, Melbourne, Australia. Electronic address: clare.holdsworth@wh.org.au.

Jenna K Lang (JK)

Department of Physiotherapy, Western Health, Melbourne, Australia. Electronic address: jenna.lang@monash.edu.

Elizabeth Hibbert (E)

Department of Physiotherapy, Western Health, Melbourne, Australia. Electronic address: elizabeth.hibbert@wh.org.au.

David Scott (D)

Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia. Electronic address: d.scott@deakin.edu.au.

Nir Eynon (N)

Institute for Health and Sport, Victoria University, Melbourne, Australia. Electronic address: Nir.Eynon@vu.edu.au.

Ravindranath Tiruvoipati (R)

Department of Intensive Care, Peninsula Health, Melbourne, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Peninsula Clinical School, Monash University, Frankston, VIC, Australia. Electronic address: rtiruvoipati@phcn.vic.gov.au.

Craig J French (CJ)

Department of Intensive Care, Western Health, Melbourne, Australia. Electronic address: craig.french@wh.org.au.

Nigel K Stepto (NK)

Institute for Health and Sport, Victoria University, Melbourne, Australia. Electronic address: Nigel.Stepto@vu.edu.au.

Samantha Bates (S)

Department of Intensive Care, Western Health, Melbourne, Australia. Electronic address: samantha.bates@wh.org.au.

Kelly L Walton (KL)

Biomedicine Discovery Institute, Monash University, Melbourne, Australia; Department of Physiology, Monash University, Australia. Electronic address: Kelly.Walton@monash.edu.

Tim M Crozier (TM)

Department of Intensive Care, Monash Health, Melbourne, Australia; Southern Clinical School, Monash University, Melbourne, Australia. Electronic address: timothy.crozier@monashhealth.org.

Terry P Haines (TP)

School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Melbourne, Australia. Electronic address: terry.haines@monash.edu.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Activin A level is associated with physical...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie grave › Activin A level is associated with physical...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système locomoteur › Force musculaire › Force de la main › Activin A level is associated with physical...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Manifestations neuromusculaires › Faiblesse musculaire › Activin A level is associated with physical...
questionsmedicales.fr › Phénomènes physiologiques de l'appareil locomoteur et du système nerveux › Phénomènes physiologiques du système nerveux › Sensation › Proprioception › Équilibre postural › Activin A level is associated with physical...
questionsmedicales.fr › Phénomènes psychologiques › Psychologie appliquée › Études ergonomiques › Activin A level is associated with physical...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Établissements de santé › Unités hospitalières › Unités de soins intensifs › Activin A level is associated with physical...