Understanding skeletal muscle wasting in critically ill patients

Methods Objective: The objective was to perform a comprehensive prospective characterization of skeletal muscle wasting, defining the pathogenic roles of altered protein synthesis and breakdown. Design: Prospective observational study. Setting: Patients were recruited from a university and community hospital in England. Subjects: The study involved 63 critically ill patients >18 years old who were anticipated to be intubated >48 hours and to spend >7 days in the ICU and to survive their ICU stay. Subjects were enrolled within 24 hours of admission. Outcomes: Muscle loss was determined through serial ultrasound measurement of the rectus femoris crosssectional area (CSA) on days 1, 3, 7, and 10. In a subset of patients, the fiber CSA area was quantified along with the ratio of protein to DNA on days 1 and 7. Histopathological analysis was performed. In addition, muscle