Rethinking Muscle Wasting in Critical Illness: A Systematic Review and Meta-Analysis of Myofiber Size and Protein Turnover.
Felipe González-Seguel, Cayla M Robinson, Camilo Caceres-Parra et al.
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In 30 seconds
This systematic review and meta-analysis examined skeletal muscle dysfunction in adults with critical illness, analyzing myofiber size and protein turnover. The study included 75 studies with 2,023 patients and 642 controls. Results showed that myofiber cross-sectional area was 22% lower in critically ill patients both before and after ICU discharge, while protein synthesis did not differ significantly from controls.
Key findings
- Myofiber cross-sectional area was 22% lower in critically ill patients before ICU discharge (MD, -689 µm²; p = 0.02).
- Myofiber cross-sectional area was also 22% lower after ICU discharge (MD, -775 µm²; p = 0.04).
- No significant difference in protein synthesis was found compared to controls (MD, 0.007%/hr; p = 0.36).
- Protein degradation markers were significantly higher in critically ill patients (standardized MD ranging, 0.5-1.7).
Why it matters
Understanding the biological mechanisms of muscle wasting in critical illness is crucial for developing interventions. The findings highlight the need for targeted strategies to address myofiber atrophy and protein degradation in this vulnerable population.