TY - JOUR
T1 - Elderly Persons with ICU-Acquired Weakness
T2 - The Potential Role for β-Hydroxy-β-Methylbutyrate (HMB) Supplementation?
AU - Rahman, Adam
AU - Wilund, Kenneth
AU - Fitschen, Peter J.
AU - Jeejeebhoy, Khursheed
AU - Agarwala, Ravi
AU - Drover, John W.
AU - Mourtzakis, Marina
PY - 2014/7
Y1 - 2014/7
N2 - Intensive care unit (ICU)-acquired weakness is common and characterized by muscle loss, weakness, and paralysis. It is associated with poor short-term outcomes, including increased mortality, but the consequences of reduced long-term outcomes, including decreased physical function and quality of life, can be just as devastating. ICU-acquired weakness is particularly relevant to elderly patients who are increasingly consuming ICU resources and are at increased risk for ICU-acquired weakness and complications, including mortality. Elderly patients often enter critical illness with reduced muscle mass and function and are also at increased risk for accelerated disuse atrophy with acute illness. Increasingly, intensivists and researchers are focusing on strategies and therapies aimed at improving long-term neuromuscular function. β-Hydroxy-β-methylbutyrate (HMB), an ergogenic supplement, has shown efficacy in elderly patients and certain clinical populations in counteracting muscle loss. The present review discusses ICU-acquired weakness, as well as the unique physiology of muscle loss and skeletal muscle function in elderly patients, and then summarizes the evidence for HMB in elderly patients and in clinical populations. We subsequently postulate on the potential role and strategies in studying HMB in elderly ICU patients to improve muscle mass and function.
AB - Intensive care unit (ICU)-acquired weakness is common and characterized by muscle loss, weakness, and paralysis. It is associated with poor short-term outcomes, including increased mortality, but the consequences of reduced long-term outcomes, including decreased physical function and quality of life, can be just as devastating. ICU-acquired weakness is particularly relevant to elderly patients who are increasingly consuming ICU resources and are at increased risk for ICU-acquired weakness and complications, including mortality. Elderly patients often enter critical illness with reduced muscle mass and function and are also at increased risk for accelerated disuse atrophy with acute illness. Increasingly, intensivists and researchers are focusing on strategies and therapies aimed at improving long-term neuromuscular function. β-Hydroxy-β-methylbutyrate (HMB), an ergogenic supplement, has shown efficacy in elderly patients and certain clinical populations in counteracting muscle loss. The present review discusses ICU-acquired weakness, as well as the unique physiology of muscle loss and skeletal muscle function in elderly patients, and then summarizes the evidence for HMB in elderly patients and in clinical populations. We subsequently postulate on the potential role and strategies in studying HMB in elderly ICU patients to improve muscle mass and function.
KW - adult
KW - critical care
KW - nutrition
UR - http://www.scopus.com/inward/record.url?scp=84904756679&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904756679&partnerID=8YFLogxK
U2 - 10.1177/0148607113502545
DO - 10.1177/0148607113502545
M3 - Review article
C2 - 24072740
AN - SCOPUS:84904756679
SN - 0148-6071
VL - 38
SP - 567
EP - 575
JO - Journal of Parenteral and Enteral Nutrition
JF - Journal of Parenteral and Enteral Nutrition
IS - 5
ER -