Bone metabolism and fracture risk during and after critical illness.

Abstract:

PURPOSE OF REVIEW:There is growing evidence that bone health is impacted during and after critical illness in multiple ways. In this review, we provide a practical update on postcritical care bone loss with an insight on identification of persons at risk, prevention and treatment strategies. RECENT FINDINGS:Critical illness is associated with an increase in bone turnover and with an uncoupling between bone resorption and bone formation. This results in loss of bone mass, as highlighted by changes in bone marker serum levels and in bone mineral density. Data suggest that ICU survivors are at an increased risk of bone fractures, but this is not completely quantifiable. A key driving factor for ICU-related bone loss, beside inflammation, undernutrition and vitamin D deficiency, is immobilization. Bone health and muscle health are closely related, through myokines and osteokines. Even if not completely proven in the context of critical care, it is likely that preserving muscle mass and strength helps reducing bone loss. SUMMARY:A history of critical illness should be considered as a strong risk factor for osteopenia and osteoporosis. ICU-related bone loss should be part of the postintensive care syndrome, and should be targeted by prevention and treatment strategies. Optimized and individualized protein and micronutrient provision (with specific attention to calcium, vitamin D and selenium), associated with physiotherapy and muscle training, should be implemented early after ICU admission and continued after ICU discharge. Antiresorptive agents such as biphosphonates should be considered on an individualized basis.

journal_name

Curr Opin Crit Care

authors

Rousseau AF,Kerschan-Schindl K,Scherkl M,Amrein K

doi

10.1097/MCC.0000000000000734

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

379-385

issue

4

eissn

1070-5295

issn

1531-7072

journal_volume

26

pub_type

杂志文章,评审
  • Optimal use of existing and new antifungal drugs.

    abstract::Clinicians are increasingly aware that fungal pathogens are a significant cause of morbidity and mortality in hospitalized patients. Historically, these infections occurred in severely immunocompromised patients who were undergoing treatment for hematological malignancy or solid organ transplantation. Currently, howev...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200108000-00005

    authors: Rogers TR

    更新日期:2001-08-01 00:00:00

  • From persistence to palliation: limiting active treatment in the ICU.

    abstract:PURPOSE OF REVIEW:End-of-life care and communication deficits are important sources of conflicts within ICU teams and with patients or families. This narrative review describes recent studies on how to improve palliative care and surrogate decision-making in ICUs and compares the results with previously published liter...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e328358d417

    authors: Wiedermann CJ,Lehner GF,Joannidis M

    更新日期:2012-12-01 00:00:00

  • Nutritional and metabolic supplementation for the injured brain: an update.

    abstract:PURPOSE OF REVIEW:Energy dysfunction is increasingly recognized as a key factor in the pathogenesis of acute brain injury (ABI). This one characterized by a high metabolic rate and nitrogen loss is often associated with an undernutrition support. We review the metabolism evolution and nutritional status in brain injure...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000588

    authors: Quintard H,Ichai C

    更新日期:2019-04-01 00:00:00

  • Update on the management of acute liver failure.

    abstract:PURPOSE OF REVIEW:This review describes the current intensive care management of acute liver failure (ALF) and the latest evidence for emerging therapies. RECENT FINDINGS:Mortality from ALF continues to improve and in some cases, medical therapy can negate the need for liver transplantation because of protocolized man...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000583

    authors: Trovato FM,Rabinowich L,McPhail MJW

    更新日期:2019-04-01 00:00:00

  • The effects of mechanical ventilation on hepato-splanchnic perfusion.

    abstract:PURPOSE OF REVIEW:Mechanical ventilation is a cornerstone of ICU treatment. Because of its interaction with blood flow and intra-abdominal pressure, mechanical ventilation has the potential to alter hepato-splanchnic perfusion, abdominal organ function and thereby outcome of the most critically ill patients. RECENT FI...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章

    doi:10.1097/MCC.0b013e3283374b1c

    authors: Jakob SM

    更新日期:2010-04-01 00:00:00

  • Quality of life and prognosis among survivors of out-of-hospital cardiac arrest.

    abstract:PURPOSE OF REVIEW:We reviewed the topic of quality of life and prognosis of out-of-hospital cardiac arrest survivors, focusing on more recent developments. RECENT FINDINGS:In 2003 to 2004, published experiences from Canada, the United States, and Europe indicate that the quality of life among out-of-hospital cardiac a...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000125494.84614.fb

    authors: Rea TD,Paredes VL

    更新日期:2004-06-01 00:00:00

  • Recent developments in percutaneous tracheostomy: improving techniques and expanding roles.

    abstract:PURPOSE OF REVIEW:The purpose of this review is to provide an update of recent developments pertaining to the use of percutaneous tracheostomy. Percutaneous tracheostomy has been established as an alternative to open surgical tracheostomy, but many key questions about the optimal use of this procedure remain unanswered...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000170680.09759.f2

    authors: Bardell T,Drover JW

    更新日期:2005-08-01 00:00:00

  • Renal dysfunction and fluid and electrolyte disturbances.

    abstract:PURPOSE OF REVIEW:To examine recent developments in preventing and treating postoperative acute renal dysfunction. To review contemporary issues concerning perioperative fluid and electrolyte management. RECENT FINDINGS:Renal dysfunction remains a major postoperative morbidity despite the advent of intermittent and co...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e328348bef5

    authors: Hashem R,Weissman C

    更新日期:2011-08-01 00:00:00

  • How to assess liver function?

    abstract:PURPOSE OF REVIEW:The liver comprises a multitude of parenchymal and nonparenchymal cells with diverse metabolic, hemodynamic and immune functions. Available monitoring options consist of 'static' laboratory parameters, quantitative tests of liver function based on clearance, elimination or metabolite formation and sco...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3283361813

    authors: Kortgen A,Recknagel P,Bauer M

    更新日期:2010-04-01 00:00:00

  • Nutritional assessment and support of the patient with acute heart failure.

    abstract:PURPOSE OF REVIEW:A significant number of patients hospitalized with heart failure are malnourished. Depletion of micronutrients, which is known to occur in heart failure for a variety of reasons, may contribute to myocardial abnormalities noted in heart failure. In this review, we focus on nutritional supplementation ...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e32833e10d4

    authors: Sarma S,Gheorghiade M

    更新日期:2010-10-01 00:00:00

  • Weaning the patient: between protocols and physiology.

    abstract:PURPOSE OF REVIEW:Ventilator weaning forms an integral part in critical care medicine and strategies to shorten duration are rapidly evolving alongside our knowledge of the relevant physiological processes. The purpose of the current review is to discuss new physiological and clinical insights in ventilator weaning tha...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章

    doi:10.1097/MCC.0000000000000790

    authors: Haaksma ME,Tuinman PR,Heunks L

    更新日期:2021-02-01 00:00:00

  • Helicopter transport: help or hindrance?

    abstract:PURPOSE OF REVIEW:Traumatic injury continues to be a significant cause of morbidity and mortality in the year 2011. In addition, the healthcare expenditures and lost years of productivity represent significant economic cost to the affected individuals and their communities. Helicopters have been used to transport traum...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e32834c5655

    authors: Plevin RE,Evans HL

    更新日期:2011-12-01 00:00:00

  • New modes of mechanical ventilation: proportional assist ventilation, neurally adjusted ventilatory assist, and fractal ventilation.

    abstract::Increased knowledge of the mechanisms that determine respiratory failure has led to the development of new technologies aimed at improving ventilatory treatment. Proportional assist ventilation and neurally adjusted ventilatory assist have been designed with the goal of improving patient-ventilator interaction by matc...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200302000-00010

    authors: Navalesi P,Costa R

    更新日期:2003-02-01 00:00:00

  • Community-acquired pneumonia as an emergency condition.

    abstract:PURPOSE OF REVIEW:Despite the improvements in its management, community-acquired pneumonia (CAP) still exhibits high global morbidity and mortality rates, especially in elderly patients. This review focuses on the most recent findings on the epidemiology, cause, diagnosis and management of CAP. RECENT FINDINGS:There i...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000550

    authors: Cillóniz C,Dominedò C,Garcia-Vidal C,Torres A

    更新日期:2018-12-01 00:00:00

  • ICU-based rehabilitation and its appropriate metrics.

    abstract:PURPOSE OF REVIEW:Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early rehabilitation of ICU patients has recently been identified as an important focus for interdisciplinary ICU teams. However, the amount of rehabilitation...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e328357f022

    authors: Gosselink R,Needham D,Hermans G

    更新日期:2012-10-01 00:00:00

  • Refractory status epilepticus.

    abstract:PURPOSE OF REVIEW:Although conventional anticonvulsant agents can terminate status epilepticus in most cases, a substantial minority of patients develops medically refractory status and requires more aggressive care. This review explores the options available. RECENT FINDINGS:Increasing numbers of previously unexpecte...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000157079.72999.87

    authors: Bleck TP

    更新日期:2005-04-01 00:00:00

  • Should we use driving pressure to set tidal volume?

    abstract:PURPOSE OF REVIEW:Ventilator-induced lung injury (VILI) can occur despite use of tidal volume (VT) limited to 6 ml/kg of predicted body weight, especially in patients with a smaller aerated compartment (i.e. the baby lung) in which, indeed, tidal ventilation takes place. Because respiratory system static compliance (CR...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000377

    authors: Grieco DL,Chen L,Dres M,Brochard L

    更新日期:2017-02-01 00:00:00

  • Improving outcomes in the early phases after major trauma.

    abstract:PURPOSE OF REVIEW:The scope of this review is to describe what is known about injury outcomes and the principles by which they can be improved by acute phase interventions. Assessing which outcomes matter to trauma patients is important both for the evaluation of existing and novel acute interventions and to assess the...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e32834a9353

    authors: Brohi K,Cole E,Hoffman K

    更新日期:2011-10-01 00:00:00

  • Eyeing up the injured brain: automated pupillometry and optic nerve sheath diameter.

    abstract:PURPOSE OF REVIEW:Multimodal monitoring has emerged as a novel paradigm of care in acute brain injury, and in this context the value of noninvasive devices is increasingly under scrutiny. This narrative review summarizes recent clinical investigation focused on the role of automated infrared pupillometry (AIP) and opti...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000710

    authors: Romagnosi F,Bongiovanni F,Oddo M

    更新日期:2020-04-01 00:00:00

  • Mechanical ventilation strategies for the surgical patient.

    abstract:PURPOSE OF REVIEW:To summarize clinical evidence for intraoperative ventilation settings, which could protect against postoperative pulmonary complications (PPCs) in surgical patients with uninjured lungs. RECENT FINDINGS:There is convincing evidence for protection against PPCs by low tidal volumes: benefit was found ...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000215

    authors: Schultz MJ,Abreu MG,Pelosi P

    更新日期:2015-08-01 00:00:00

  • Uncertainty in end-of-life care.

    abstract:PURPOSE OF REVIEW:Uncertainty surrounding medical decision-making is particularly important during end-of-life decision-making. Doubts about the patient's best interests and prognostic accuracy may lead to conflict. RECENT FINDINGS:Many authors have suggested recently that medical attitudes to uncertainty need review....

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000030

    authors: Ridley S,Fisher M

    更新日期:2013-12-01 00:00:00

  • Haemodynamic and ventilator management in patients following cardiac arrest.

    abstract:PURPOSE OF REVIEW:The purpose of this study is to review the recent literature describing how to assess and treat postcardiac arrest syndrome associated haemodynamics and manage oxygenation and ventilation derangements. RECENT FINDINGS:Postcardiac arrest syndrome is a well described entity that includes systemic ische...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000205

    authors: Topjian AA,Berg RA,Taccone FS

    更新日期:2015-06-01 00:00:00

  • Percutaneous left ventricular assist devices for treatment of patients with cardiogenic shock.

    abstract:PURPOSE OF REVIEW:This review will discuss the rationale and clinical utility of percutaneous left ventricular assist devices in the management of patients with cardiogenic shock. RECENT FINDINGS:Left ventricular assist devices maintain partial or total circulatory support in case of severe left ventricular failure. C...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3282efd5bc

    authors: Windecker S

    更新日期:2007-10-01 00:00:00

  • EBM vs. EBM: combining evidence-based and experienced-based medicine in resuscitation research.

    abstract:PURPOSE OF REVIEW:To discuss the clear rationale for evidence-based medicine (EvBM) in the challenging realms of resuscitation research, yet also provide case examples in which even the well designed, multicentered randomized clinical trial may have had unrecognized limitations, and thus misleading results. This is whe...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000413

    authors: Pepe PE,Aufderheide TP

    更新日期:2017-06-01 00:00:00

  • Fluid choices impact outcome in septic shock.

    abstract:PURPOSE OF REVIEW:We discuss the goals of resuscitation, in both the early and the later phases, measures of organ perfusion, fluid responsiveness and the consequences of tissue edema. RECENT FINDINGS:The cost of over-aggressive fluid resuscitation is increased organ failure and mortality. In anticipation of the upcom...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000116

    authors: Douglas JJ,Walley KR

    更新日期:2014-08-01 00:00:00

  • Early prognostication in acute brain damage: where is the evidence?

    abstract:PURPOSE OF REVIEW:Early prognostication in acute brain damage remains a challenge in the realm of critical care. There remains controversy over the most optimal methods that can be utilized to predict outcome. The utility of recently reported prognostic biomarkers and clinical methods will be reviewed. RECENT FINDINGS...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e32835eba56

    authors: Kalanuria AA,Geocadin RG

    更新日期:2013-04-01 00:00:00

  • Prerenal failure: from old concepts to new paradigms.

    abstract:PURPOSE OF REVIEW:Prerenal failure is used to designate a reversible form of acute renal dysfunction. However, the terminology encompasses several different conditions that vary considerably. The lack of a widely accepted definition for prerenal failure makes it impossible to determine the epidemiology, natural history...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章

    doi:10.1097/MCC.0b013e328332f6e3

    authors: Macedo E,Mehta RL

    更新日期:2009-12-01 00:00:00

  • Selenium in critical illness.

    abstract:PURPOSE OF REVIEW:Selenium is a trace element essential to human health. Critical illness is associated with the generation of oxygen free radicals resulting in a condition of oxidative stress. Supplementing critically ill patients with antioxidant nutrients may improve survival. Selenium levels can be low due to redis...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000216581.80051.d6

    authors: Geoghegan M,McAuley D,Eaton S,Powell-Tuck J

    更新日期:2006-04-01 00:00:00

  • Overview of ventilator-induced lung injury mechanisms.

    abstract:PURPOSE OF REVIEW:Mechanical ventilation is the main supportive therapy for patients with acute respiratory distress syndrome. As with any therapy, mechanical ventilation has side effects and may induce lung injury. This review will focus on stretch-dependent activation of alveolar epithelial and endothelial cells and ...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200502000-00013

    authors: Lionetti V,Recchia FA,Ranieri VM

    更新日期:2005-02-01 00:00:00

  • When and how should we do a tracheostomy?

    abstract::Tracheostomy is one of the most common surgical procedures in the intensive care unit. Since the introduction of percutaneous techniques, tracheostomy has become increasingly popular. The technique is relatively easy, and the early and late complication rates are relatively low.It is unknown at which moment tracheosto...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章

    doi:10.1097/00075198-200008000-00005

    authors: van Heurn LW

    更新日期:2000-08-01 00:00:00