Browsing by Author "Mayer, Kirby P."
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Publication Critical illness myopathy and trajectory of recovery in acute kidney injury requiring continuous renal replacement therapy: a prospective observational trial protocol(2023) J Pedro Teixeira, J. Pedro; Griffin, Benjamin R.; Pal, Chaitanya Anil; González Seguel, Felipe; Jenkins, Nathanial; Jones, Beth M.; Yoshida, Yuri; George, Naomi; Israel, Hayley Puffer; Ghazi, Lama; Neyra, Javier A.; Mayer, Kirby P.Introduction Acute kidney injury requiring renal replacement therapy (AKI- RRT) is common in the intensive care unit (ICU) and is associated with significant morbidity and mortality. Continuous RRT (CRRT) non- selectively removes large amounts of amino acids from plasma, lowering serum amino acid concentrations and potentially depleting total- body amino acid stores. Therefore, the morbidity and mortality associated with AKI- RRT may be partly mediated through accelerated skeletal muscle atrophy and resulting muscle weakness. However, the impact of AKI- RRT on skeletal muscle mass and function during and following critical illness remains unknown. We hypothesise that patients with AKI- RRT have higher degrees of acute muscle loss than patients without AKI- RRT and that AKI- RRT survivors are less likely to recover muscle mass and function when compared with other ICU survivors. Methods and analysis This protocol describes a prospective, multicentre, observational trial assessing skeletal muscle size, quality and function in ICU patients with AKI- RRT. We will perform musculoskeletal ultrasound to longitudinally evaluate rectus femoris size and quality at baseline (within 48 hours of CRRT initiation), day 3, day 7 or at ICU discharge, at hospital discharge, and 1–3 months postdischarge. Additional skeletal muscle and physical function tests will be performed at hospital discharge and postdischarge follow- up. We will analyse the effect of AKI- RRT by comparing the findings in enrolled subjects to historical controls of critically ill patients without AKI- RRT using multivariable modelling. Ethics and dissemination We anticipate our study will reveal that AKI- RRT is associated with greater degrees of muscle loss and dysfunction along with impaired postdischarge recovery of physical function. These findings could impact the in- hospital and postdischarge treatment plan for these patients to include focused attention on muscle strength and function. We intend to disseminate findings to participants, healthcare professionals, the public and other relevant groups via conference resentation and publication without any publication restrictions.Publication Muscle Dysfunction and Physical Recovery After Critical Illness(2025) Mart, Matthew F.; Gordon, Joshua I.; González-Seguel, Felipe; Mayer, Kirby P.; Brummel, NathanDuring critical illness, patients experience significant and rapid onsets of muscle wasting and dysfunction with loss of strength, mass, and power. These deficits often persist long after the ICU, leading to impairments in physical function including reduced exercise capacity and increased frailty and disability. While there are numerous studies describing the epidemiology of impaired muscle and physical function in the ICU, there are significantly fewer data investigating mechanisms of prolonged and persistent impairments in ICU survivors. Additionally, while several potential clinical risk factors associated with poor physical recovery have been identified, there remains a dearth of interventions that have effectively improved outcomes long-term among survivors. In this article, we aim to provide a thorough, evidence-based review of the current state of knowledge regarding muscle dysfunction and physical function after critical illness with a focus on post-ICU and post-hospitalization phase of recovery.