The 110th Abbott Nutrition Research Conference

June 23-25, 2009,
Columbus, Ohio
Acquired Weakness in Critically Ill Patients

Gerald Supinski, MD, University of Kentucky, Lexington, Kentucky
Critically ill patients often face the peculiar challenge of both skeletal and respiratory muscle wasting.  The cause of lean body mass loss is multi-factorial and this loss results in the activtion of several cellular pathways.  This presentation investigates the mechanisms responsible for increased protein degradation and decreased protein synthesis.  By understanding this process, better therapies can be developed that decrease the morbidity from acquired weakness.

Conference Videos
Loss of muscle is associated with weakness, fatigue, insulin resistance, falls, fear of falling, fractures, frailty, disability, and death. Anorexia, sarcopenia, and cachexia each contribute to the decline in muscle mass in unique ways. This article summarizes the causes and outcomes of skeletal muscle loss as well as current recommended nutritional interventions in the prevention and reversal of muscle loss.
Aging is associated with a loss in muscle mass and a gain in fat mass. These changes are related to a decrease in overall health and functional ability. Advancing sarcopenia is associated with increased risk of fall and fractures, decreased ability to complete activities of daily living, and increase in fatigue, all leading to dependency and disability. This paper examines the effects of several factors, including protein consumption and exercise, that promote optimal muscle protein synthesis with age.
Sarcopenia is an age-related loss in lean body mass accelerated by poor nutrition and physical inactivity. To counteract this loss of muscle, patients should consume protein in adequate quantities and at proper times. This article investigates the effects of physical inactivity on lean body mass loss and the ingestion of protein on lean body mass accretion.
Cachexia is characterized by a loss of muscle with or without a loss of fat mass. With the increasing prevalence of overweight and obesity, emaciation is becoming less common. Even after considerable weight loss from cancer cachexia, many patients are still considered overweight or obese. This article advocates measuring lean body mass, rather than the traditional method of observing weight loss, to better identify cachexia.
Acquired Weakness in Critically Ill Patients
Critically ill patients often face the peculiar challenge of both skeletal and respiratory muscle wasting.  The cause of lean body mass loss is multi-factorial and this loss results in the activtion of several cellular pathways. This presentation investigates the mechanisms responsible for increased protein degradation and decreased protein synthesis.  By understanding this process, better therapies can be developed that decrease the morbidity from acquired weakness.

*at no charge