Myopathies related to critical illness have received increasing recognition over the past decade and are common in patients even after a brief period in the intensive care unit. Recent studies have revealed that myopathies in the critically ill may in fact be more prevalent than neuropathies and that morbidity and mortality may be greater. Protein catabolism, an increase in urinary nitrogen los...

Introduction As early recognition, resuscitation and technological advancement in the treatment of critically ill patients have improved, efforts to understand patient outcomes after an acute period of illness are being undertaken. While it has been noted that one-year mortality among survivors of critical illness is extremely high, awareness is increasing regarding patients who, despite surviv...

Critically ill older patients with sarcopenia experience greater morbidity and mortality than younger patients. It is anticipated that unabated protein catabolism would be detrimental for the critically ill older patient. Healthy older subjects experience a diminished response to protein supplementation when compared to their younger counterparts, but this anabolic resistance can be overcome by...

PURPOSE OF REVIEW Adrenal insufficiency is being diagnosed with increasing frequency in critically ill patients. There exists, however, much controversy in the literature as to the nature of this entity, including its pathophysiology, epidemiology, diagnosis and treatment. The review summarizes our current understanding of the causes and consequences of adrenal insufficiency in critically ill p...

The metabolic support of the critically ill patient is a relatively new target of active research and little is as yet known about the effects of critical illness on metabolism. The nonthyroidal illness syndrome, also known as the low T3 syndrome or euthyroid sick syndrome, describes a condition characterized by abnormal thyroid function tests encountered in patients with acute or chronic syste...

重症患者に対するリハビリテーションの目的は，日常生活活動（activities of daily living, ADL）を維持，改善，再獲得することで，QOLを改善することである。重症患者に対するリハビリテーションはABCDEFバンドルの一つの要素として捉え，集中治療後症候群ost-intensive care syndrome, PICS）予防のために包括的な介入を行うべきである。重症患者においてリハビリテーションは死亡を改善しないが，身体機能やADLを改善するため，国内外のガイドラインで実施が推奨されている。近年はPICS予防のためのICU入室中のリハビリテーションだけでなく，ICU退室後のリハビリテーションやフォローアップが注目されている。臨床現場で遭遇する様々な障害や疾患に対するICU内およびICU退院後のリハビリテーションの最適な量，頻度，強度，期間，および種類を明らかに...

INTRODUCTION Previous studies report the spectrum of thyroid function abnormalities in critically-ill neonates. In this study, we evaluated the thyroid status in critically-ill neonates, and determined whether thyroid function abnormalities are more common in sick neonatal infants. METHODS In a prospective cohort study, 67 critically-ill infants from the Neonatal Intensive Care Unit (NICU), a...

INTRODUCTION We recently reported macrophage accumulation in adipose tissue of critically ill patients. Classically activated macrophage accumulation in adipose tissue is a known feature of obesity, where it is linked with increasing insulin resistance. However, the characteristics of adipose tissue macrophage accumulation in critical illness remain unknown. METHODS We studied macrophage mark...

BACKGROUND AND AIMS Down-regulation of miR-150 was recently linked to inflammation and bacterial infection. Furthermore, reduced serum levels of miR-150 were reported from a small cohort of patients with sepsis. We thus aimed at evaluating the diagnostic and prognostic value of miR-150 serum levels in patients with critically illness and sepsis. METHODS miR-150 serum levels were analyzed in a...

OBJECTIVES The cortisol response during critical illness varies widely among patients. Our objective was to examine single nucleotide polymorphisms in candidate genes regulating cortisol synthesis, metabolism, and activity to determine if genetic differences were associated with variability in the cortisol response among critically ill children. DESIGN This was a prospective observational stu...