Evaluating muscle mass in survivors of acute respiratory distress syndrome: A 1-year multicenter longitudinal study

Kitty S. Chan; Marina Mourtzakis; Lisa Aronson Friedman; Victor D. Dinglas; Catherine L. Hough; E. Wesley Ely; Peter E. Morris; Ramona O. Hopkins; Dale M. Needham

doi:10.1097/CCM.0000000000003183

Evaluating muscle mass in survivors of acute respiratory distress syndrome: A 1-year multicenter longitudinal study

Kitty S. Chan, Marina Mourtzakis, Lisa Aronson Friedman, Victor D. Dinglas, Catherine L. Hough, E. Wesley Ely, Peter E. Morris, Ramona O. Hopkins, Dale M. Needham

Research output: Contribution to journal › Article › peer-review

35 Scopus citations

Abstract

Objectives: Rapid muscle wasting occurs during acute respiratory failure, resulting in muscle weakness and functional impairments. This study examines survivors' body composition in the year after acute respiratory distress syndrome and tests associations of patient characteristics, hospital exposures, and survivors' strength and physical functioning with whole body percent lean mass. Design: Prospective cohort study with 6- and 12-month follow-up. Setting: National study enrolling patients from five study centers. Patients: Acute respiratory distress syndrome survivors (n = 120). Interventions: None. Measurements and Main Results: Lean and fat mass from dual energy x-ray absorptiometry. On average, survivors gained whole body total mass (+1.4 kg; 0.1-2.7) and fat mass (+1.2 kg; 0.2-2.2) and maintained lean mass (+0.2 kg; -0.4 to 0.8) between 6 and 12 months. Proportionally, percent fat mass increased and percent lean mass decreased for the whole body, trunk, and legs (p < 0.05). Greater whole body percent lean mass was associated with younger age, male sex, and lower baseline body mass index, but not other patient characteristics or ICU/hospital exposures. Greater percent lean mass was also significantly associated with gait speed and 6-minute walk distance, but not volitional strength or self-reported functional status. Conclusions: In the first year after acute respiratory distress syndrome, patients gained fat mass and maintained lean mass. We found no association of whole body percent lean mass with commonly hypothesized hospital risk factors. Direct measurement of body composition and performance-based functional measures may be helpful for understanding functional recovery in ICU survivors.

Original language	English
Pages (from-to)	1238-1246
Number of pages	9
Journal	Critical Care Medicine
Volume	46
Issue number	8
DOIs	https://doi.org/10.1097/CCM.0000000000003183
State	Published - 2018

Bibliographical note

Funding Information:
Drs. Chan, Mourtzakis, and Needham conceived and designed the study. All authors contributed to the analysis plan and involved in the interpretation of study results. Drs. Dinglas, Hough, Ely, Morris, Hopkins, and Needham acquired the data, and Ms. Aronson Friedman performed all analyses. Drs. Chan and Mourtzakis drafted the article, and all authors critically revised it for important intellectual content and approved the final version to be submitted. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal). Supported, in part, by the National Heart, Lung, and Blood Institute (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, Copyright © 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Funding Information:
Drs. Chan, Aronson Friedman, Dinglas, Hough, Ely, Hopkins, and Needham received support for article research from the National Institutes of Health (NIH). Drs. Chan’s and Friedman’s institutions received funding from the National Heart, Lung, and Blood Institute. Drs. Hough’s, Ely’s, Hopkin’s, and Needham’s institutions received funding from the NIH. Dr. Ely’s institution also received funding from Veterans Administration funding, and he received funding from Orion, Abbott, and Pfizer. Dr. Needham’s institution also received funding from the National Health and Medical Research Council, Australia, the Gordon & Betty Moore Foundation, Reck Medical Devises, and Baxter Healthcare. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: kchan10@jhu.edu

Funding Information:
Supported, in part, by the National Heart, Lung, and Blood Institute (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, R01HL88045 and P050HL73994), the Johns Hopkins Institute for Clinical and Translational Research (UL1 TR 000424-06), and the Albuterol for the Treatment of ALI (ALTA), Early vs. Delayed Enteral Nutrition (EDEN), Omega Nutrition Supplement Trial (OMEGA), and Statins for Acutely Injured Lungs from Sepsis (SAILS) trials (contracts for sites participating in this study: HSN268200536170C, HHSN268200536171C, HHSN268200536173C, HHSN268200536174C, HSN268200536175C, and HHSN268200536179C).

Publisher Copyright:
Copyright © 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

Keywords

Acute respiratory distress syndrome
Anthropometry
Dual energy x-ray absorptiometry
Lean mass
Longitudinal studies

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine

Access to Document

10.1097/CCM.0000000000003183

Cite this

@article{c2004e98f4b9427ba1053329fea0ec51,

title = "Evaluating muscle mass in survivors of acute respiratory distress syndrome: A 1-year multicenter longitudinal study",

abstract = "Objectives: Rapid muscle wasting occurs during acute respiratory failure, resulting in muscle weakness and functional impairments. This study examines survivors' body composition in the year after acute respiratory distress syndrome and tests associations of patient characteristics, hospital exposures, and survivors' strength and physical functioning with whole body percent lean mass. Design: Prospective cohort study with 6- and 12-month follow-up. Setting: National study enrolling patients from five study centers. Patients: Acute respiratory distress syndrome survivors (n = 120). Interventions: None. Measurements and Main Results: Lean and fat mass from dual energy x-ray absorptiometry. On average, survivors gained whole body total mass (+1.4 kg; 0.1-2.7) and fat mass (+1.2 kg; 0.2-2.2) and maintained lean mass (+0.2 kg; -0.4 to 0.8) between 6 and 12 months. Proportionally, percent fat mass increased and percent lean mass decreased for the whole body, trunk, and legs (p < 0.05). Greater whole body percent lean mass was associated with younger age, male sex, and lower baseline body mass index, but not other patient characteristics or ICU/hospital exposures. Greater percent lean mass was also significantly associated with gait speed and 6-minute walk distance, but not volitional strength or self-reported functional status. Conclusions: In the first year after acute respiratory distress syndrome, patients gained fat mass and maintained lean mass. We found no association of whole body percent lean mass with commonly hypothesized hospital risk factors. Direct measurement of body composition and performance-based functional measures may be helpful for understanding functional recovery in ICU survivors.",

keywords = "Acute respiratory distress syndrome, Anthropometry, Dual energy x-ray absorptiometry, Lean mass, Longitudinal studies",

author = "Chan, {Kitty S.} and Marina Mourtzakis and Friedman, {Lisa Aronson} and Dinglas, {Victor D.} and Hough, {Catherine L.} and Ely, {E. Wesley} and Morris, {Peter E.} and Hopkins, {Ramona O.} and Needham, {Dale M.}",

note = "Funding Information: Drs. Chan, Mourtzakis, and Needham conceived and designed the study. All authors contributed to the analysis plan and involved in the interpretation of study results. Drs. Dinglas, Hough, Ely, Morris, Hopkins, and Needham acquired the data, and Ms. Aronson Friedman performed all analyses. Drs. Chan and Mourtzakis drafted the article, and all authors critically revised it for important intellectual content and approved the final version to be submitted. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal{\textquoteright}s website (http://journals.lww.com/ccmjournal). Supported, in part, by the National Heart, Lung, and Blood Institute (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, Copyright {\textcopyright} 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Funding Information: Drs. Chan, Aronson Friedman, Dinglas, Hough, Ely, Hopkins, and Needham received support for article research from the National Institutes of Health (NIH). Drs. Chan{\textquoteright}s and Friedman{\textquoteright}s institutions received funding from the National Heart, Lung, and Blood Institute. Drs. Hough{\textquoteright}s, Ely{\textquoteright}s, Hopkin{\textquoteright}s, and Needham{\textquoteright}s institutions received funding from the NIH. Dr. Ely{\textquoteright}s institution also received funding from Veterans Administration funding, and he received funding from Orion, Abbott, and Pfizer. Dr. Needham{\textquoteright}s institution also received funding from the National Health and Medical Research Council, Australia, the Gordon & Betty Moore Foundation, Reck Medical Devises, and Baxter Healthcare. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: kchan10@jhu.edu Funding Information: Supported, in part, by the National Heart, Lung, and Blood Institute (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, R01HL88045 and P050HL73994), the Johns Hopkins Institute for Clinical and Translational Research (UL1 TR 000424-06), and the Albuterol for the Treatment of ALI (ALTA), Early vs. Delayed Enteral Nutrition (EDEN), Omega Nutrition Supplement Trial (OMEGA), and Statins for Acutely Injured Lungs from Sepsis (SAILS) trials (contracts for sites participating in this study: HSN268200536170C, HHSN268200536171C, HHSN268200536173C, HHSN268200536174C, HSN268200536175C, and HHSN268200536179C). Publisher Copyright: Copyright {\textcopyright} 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.",

year = "2018",

doi = "10.1097/CCM.0000000000003183",

language = "English",

volume = "46",

pages = "1238--1246",

number = "8",

}

TY - JOUR

T1 - Evaluating muscle mass in survivors of acute respiratory distress syndrome

T2 - A 1-year multicenter longitudinal study

AU - Chan, Kitty S.

AU - Mourtzakis, Marina

AU - Friedman, Lisa Aronson

AU - Dinglas, Victor D.

AU - Hough, Catherine L.

AU - Ely, E. Wesley

AU - Morris, Peter E.

AU - Hopkins, Ramona O.

AU - Needham, Dale M.

N1 - Funding Information: Drs. Chan, Mourtzakis, and Needham conceived and designed the study. All authors contributed to the analysis plan and involved in the interpretation of study results. Drs. Dinglas, Hough, Ely, Morris, Hopkins, and Needham acquired the data, and Ms. Aronson Friedman performed all analyses. Drs. Chan and Mourtzakis drafted the article, and all authors critically revised it for important intellectual content and approved the final version to be submitted. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal). Supported, in part, by the National Heart, Lung, and Blood Institute (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, Copyright © 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Funding Information: Drs. Chan, Aronson Friedman, Dinglas, Hough, Ely, Hopkins, and Needham received support for article research from the National Institutes of Health (NIH). Drs. Chan’s and Friedman’s institutions received funding from the National Heart, Lung, and Blood Institute. Drs. Hough’s, Ely’s, Hopkin’s, and Needham’s institutions received funding from the NIH. Dr. Ely’s institution also received funding from Veterans Administration funding, and he received funding from Orion, Abbott, and Pfizer. Dr. Needham’s institution also received funding from the National Health and Medical Research Council, Australia, the Gordon & Betty Moore Foundation, Reck Medical Devises, and Baxter Healthcare. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: kchan10@jhu.edu Funding Information: Supported, in part, by the National Heart, Lung, and Blood Institute (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, R01HL88045 and P050HL73994), the Johns Hopkins Institute for Clinical and Translational Research (UL1 TR 000424-06), and the Albuterol for the Treatment of ALI (ALTA), Early vs. Delayed Enteral Nutrition (EDEN), Omega Nutrition Supplement Trial (OMEGA), and Statins for Acutely Injured Lungs from Sepsis (SAILS) trials (contracts for sites participating in this study: HSN268200536170C, HHSN268200536171C, HHSN268200536173C, HHSN268200536174C, HSN268200536175C, and HHSN268200536179C). Publisher Copyright: Copyright © 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

PY - 2018

Y1 - 2018

N2 - Objectives: Rapid muscle wasting occurs during acute respiratory failure, resulting in muscle weakness and functional impairments. This study examines survivors' body composition in the year after acute respiratory distress syndrome and tests associations of patient characteristics, hospital exposures, and survivors' strength and physical functioning with whole body percent lean mass. Design: Prospective cohort study with 6- and 12-month follow-up. Setting: National study enrolling patients from five study centers. Patients: Acute respiratory distress syndrome survivors (n = 120). Interventions: None. Measurements and Main Results: Lean and fat mass from dual energy x-ray absorptiometry. On average, survivors gained whole body total mass (+1.4 kg; 0.1-2.7) and fat mass (+1.2 kg; 0.2-2.2) and maintained lean mass (+0.2 kg; -0.4 to 0.8) between 6 and 12 months. Proportionally, percent fat mass increased and percent lean mass decreased for the whole body, trunk, and legs (p < 0.05). Greater whole body percent lean mass was associated with younger age, male sex, and lower baseline body mass index, but not other patient characteristics or ICU/hospital exposures. Greater percent lean mass was also significantly associated with gait speed and 6-minute walk distance, but not volitional strength or self-reported functional status. Conclusions: In the first year after acute respiratory distress syndrome, patients gained fat mass and maintained lean mass. We found no association of whole body percent lean mass with commonly hypothesized hospital risk factors. Direct measurement of body composition and performance-based functional measures may be helpful for understanding functional recovery in ICU survivors.

AB - Objectives: Rapid muscle wasting occurs during acute respiratory failure, resulting in muscle weakness and functional impairments. This study examines survivors' body composition in the year after acute respiratory distress syndrome and tests associations of patient characteristics, hospital exposures, and survivors' strength and physical functioning with whole body percent lean mass. Design: Prospective cohort study with 6- and 12-month follow-up. Setting: National study enrolling patients from five study centers. Patients: Acute respiratory distress syndrome survivors (n = 120). Interventions: None. Measurements and Main Results: Lean and fat mass from dual energy x-ray absorptiometry. On average, survivors gained whole body total mass (+1.4 kg; 0.1-2.7) and fat mass (+1.2 kg; 0.2-2.2) and maintained lean mass (+0.2 kg; -0.4 to 0.8) between 6 and 12 months. Proportionally, percent fat mass increased and percent lean mass decreased for the whole body, trunk, and legs (p < 0.05). Greater whole body percent lean mass was associated with younger age, male sex, and lower baseline body mass index, but not other patient characteristics or ICU/hospital exposures. Greater percent lean mass was also significantly associated with gait speed and 6-minute walk distance, but not volitional strength or self-reported functional status. Conclusions: In the first year after acute respiratory distress syndrome, patients gained fat mass and maintained lean mass. We found no association of whole body percent lean mass with commonly hypothesized hospital risk factors. Direct measurement of body composition and performance-based functional measures may be helpful for understanding functional recovery in ICU survivors.

KW - Acute respiratory distress syndrome

KW - Anthropometry

KW - Dual energy x-ray absorptiometry

KW - Lean mass

KW - Longitudinal studies

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Evaluating muscle mass in survivors of acute respiratory distress syndrome: A 1-year multicenter longitudinal study

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

Access to Document

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