Institute for Human Health and Performance, University College London and Division of Asthma Allergy and Lung Biology, Kings College London, London, UK.
J Physiol. 2010 Dec 1;588(Pt 23):4641-8. doi: 10.1113/jphysiol.2010.197632. Epub 2010 Oct 20.
Impaired physical function and reduced physical activity are common findings in intensive care unit (ICU) survivors. More importantly, reduced muscle strength during critical illness is an independent predictor of survival. Skeletal muscle wasting as a direct consequence of critical illness has been suggested as the cause. However, data on the physiological processes regulating muscle mass, and function, in these critically ill patients are limited as this is not only a technically challenging research area, but also the heterogeneity of the patient group adds complexity to the interpretation of results. Despite this, clinical and research interest in this area is growing. This article highlights the issues involved in measurement of muscle function and mass in critically ill patients and the physiological complexities involved in studying these patients. Although the data are limited, this article reviews the animal and healthy human data providing a rational approach to the potential pathophysiological mechanisms involved in muscle mass regulation in critically ill patients, including the established muscle wasting 'risk factors' such as ageing, immobility and systemic inflammation, all of which are common findings in the general critical care population.
在重症监护病房 (ICU) 幸存者中，身体功能受损和身体活动减少是常见的现象。更重要的是，危重病期间肌肉力量的减少是生存的独立预测因子。有人认为，危重病直接导致的肌肉消耗是造成这种情况的原因。然而，关于调节这些危重病患者肌肉质量和功能的生理过程的数据有限，因为这不仅是一个技术上具有挑战性的研究领域，而且患者群体的异质性也使结果的解释更加复杂。尽管如此，临床和研究对这一领域的兴趣正在增长。本文重点介绍了在危重病患者中测量肌肉功能和质量所涉及的问题，以及研究这些患者所涉及的生理复杂性。尽管数据有限，但本文综述了动物和健康人类的数据，为危重病患者肌肉质量调节中涉及的潜在病理生理机制提供了合理的方法，包括已确立的肌肉消耗“危险因素”，如衰老、不动和全身炎症，这些都是普通重症监护人群中的常见现象。
