Pathophysiology and Treatment Strategies of Acute Myopathy and Muscle Wasting after Sepsis.
Robert T MankowskiOrlando LaitanoThomas L ClantonScott C BrakenridgePublished in: Journal of clinical medicine (2021)
Sepsis survivors experience a persistent myopathy characterized by skeletal muscle weakness, atrophy, and an inability to repair/regenerate damaged or dysfunctional myofibers. The origins and mechanisms of this persistent sepsis-induced myopathy are likely complex and multifactorial. Nevertheless, the pathobiology is thought to be triggered by the interaction between circulating pathogens and impaired muscle metabolic status. In addition, while in the hospital, septic patients often experience prolonged periods of physical inactivity due to bed rest, which may exacerbate the myopathy. Physical rehabilitation emerges as a potential tool to prevent the decline in physical function in septic patients. Currently, there is no consensus regarding effective rehabilitation strategies for sepsis-induced myopathy. The optimal timing to initiate the rehabilitation intervention currently lacks consensus as well. In this review, we summarize the evidence on the fundamental pathobiological mechanisms of sepsis-induced myopathy and discuss the recent evidence on in-hospital and post-discharge rehabilitation as well as other potential interventions that may prevent physical disability and death of sepsis survivors.
Keyphrases
- acute kidney injury
- septic shock
- intensive care unit
- skeletal muscle
- late onset
- end stage renal disease
- physical activity
- newly diagnosed
- chronic kidney disease
- ejection fraction
- diabetic rats
- muscular dystrophy
- high glucose
- drug induced
- randomized controlled trial
- young adults
- healthcare
- patient reported outcomes
- prognostic factors
- emergency department
- multiple sclerosis
- adipose tissue
- peritoneal dialysis
- metabolic syndrome
- type diabetes
- multidrug resistant
- oxidative stress
- patient reported
- clinical practice
- stress induced