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  1. Article ; Online: Safety and Feasibility Assessment of Repetitive Vascular Occlusion Stimulus (RVOS) Application to Multi-Organ Failure Critically Ill Patients

    Ismita Chhetri / Julie E. A. Hunt / Jeewaka R. Mendis / Lui G. Forni / Justin Kirk-Bayley / Ian White / Jonathan Cooper / Karthik Somasundaram / Nikunj Shah / Stephen D. Patterson / Zudin A. Puthucheary / Hugh E. Montgomery / Benedict C. Creagh-Brown

    Journal of Clinical Medicine, Vol 11, Iss 14, p

    A Pilot Randomised Controlled Trial

    2022  Volume 3938

    Abstract: Muscle wasting is implicated in the pathogenesis of intensive care unit acquired weakness (ICU-AW), affecting 40% of patients and causing long-term physical disability. A repetitive vascular occlusion stimulus (RVOS) limits muscle atrophy in healthy and ... ...

    Abstract Muscle wasting is implicated in the pathogenesis of intensive care unit acquired weakness (ICU-AW), affecting 40% of patients and causing long-term physical disability. A repetitive vascular occlusion stimulus (RVOS) limits muscle atrophy in healthy and orthopaedic subjects, thus, we explored its application to ICU patients. Adult multi-organ failure patients received standard care +/− twice daily RVOS {4 cycles of 5 min tourniquet inflation to 50 mmHg supra-systolic blood pressure, and 5 min complete deflation} for 10 days. Serious adverse events (SAEs), tolerability, feasibility, acceptability, and exploratory outcomes of the rectus femoris cross-sectional area (RFCSA), echogenicity, clinical outcomes, and blood biomarkers were assessed. Only 12 of the intended 32 participants were recruited. RVOS sessions (76.1%) were delivered to five participants and two could not tolerate it. No SAEs occurred; 75% of participants and 82% of clinical staff strongly agreed or agreed that RVOS is an acceptable treatment. RFCSA fell significantly and echogenicity increased in controls ( n = 5) and intervention subjects ( n = 4). The intervention group was associated with less frequent acute kidney injury (AKI), a greater decrease in the total sequential organ failure assessment score (SOFA) score, and increased insulin-like growth factor-1 (IGF-1), and reduced syndecan-1, interleukin-4 (IL-4) and Tumor necrosis factor receptor type II (TNF-RII) levels. RVOS application appears safe and acceptable, but protocol modifications are required to improve tolerability and recruitment. There were signals of possible clinical benefit relating to RVOS application.
    Keywords repetitive vascular occlusion stimulus ; ICU-acquired weakness ; blood flow restriction ; critical illness ; rehabilitation ; muscle atrophy ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-07-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Repetitive vascular occlusion stimulus (RVOS) versus standard care to prevent muscle wasting in critically ill patients (ROSProx):a study protocol for a pilot randomised controlled trial

    Ismita Chhetri / Julie E. A. Hunt / Jeewaka R. Mendis / Stephen D. Patterson / Zudin A. Puthucheary / Hugh E. Montgomery / Benedict C. Creagh-Brown

    Trials, Vol 20, Iss 1, Pp 1-

    2019  Volume 14

    Abstract: Abstract Background Forty per cent of critically ill patients are affected by intensive care unit-acquired weakness (ICU-AW), to which skeletal muscle wasting makes a substantial contribution. This can impair outcomes in hospital, and can cause long-term ...

    Abstract Abstract Background Forty per cent of critically ill patients are affected by intensive care unit-acquired weakness (ICU-AW), to which skeletal muscle wasting makes a substantial contribution. This can impair outcomes in hospital, and can cause long-term physical disability after hospital discharge. No effective mitigating strategies have yet been identified. Application of a repetitive vascular occlusion stimulus (RVOS) a limb pressure cuff inducing brief repeated cycles of ischaemia and reperfusion, can limit disuse muscle atrophy in both healthy controls and bed-bound patients recovering from knee surgery. We wish to determine whether RVOS might be effective in mitigating against muscle wasting in the ICU. Given that RVOS can also improve vascular function in healthy controls, we also wish to assess such effects in the critically ill. We here describe a pilot study to assess whether RVOS application is safe, tolerable, feasible and acceptable for ICU patients. Methods This is a randomised interventional feasibility trial. Thirty-two ventilated adult ICU patients with multiorgan failure will be recruited within 48 h of admission and randomised to either the intervention arm or the control arm. Intervention participants will receive RVOS twice daily (except only once on day 1) for up to 10 days or until ICU discharge. Serious adverse events and tolerability (pain score) will be recorded; feasibility of trial procedures will be assessed against pre-specified criteria and acceptability by semi-structured interview. Together with vascular function, muscle mass and quality will be assessed using ultrasound and measures of physical function at baseline, on days 6 and 11 of study enrolment, and at ICU and hospital discharge. Blood and urine biomarkers of muscle metabolism, vascular function, inflammation and DNA damage/repair mechanism will also be analysed. The Health questionnaire will be completed 3 months after hospital discharge. Discussion If this study demonstrates feasibility, the derived data will be used to ...
    Keywords Repetitive vascular occlusion stimulus ; ICU-acquired weakness ; Blood flow restriction ; Critical illness ; Rehabilitation ; Muscle atrophy ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2019-07-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  3. Article ; Online: Impact of liver fat on the differential partitioning of hepatic triacylglycerol into VLDL subclasses on high and low sugar diets.

    Umpleby, A Margot / Shojaee-Moradie, Fariba / Fielding, Barbara / Li, Xuefei / Marino, Andrea / Alsini, Najlaa / Isherwood, Cheryl / Jackson, Nicola / Ahmad, Aryati / Stolinski, Michael / Lovegrove, Julie A / Johnsen, Sigurd / Jeewaka R Mendis, A S / Wright, John / Wilinska, Malgorzata E / Hovorka, Roman / Bell, Jimmy D / Thomas, E Louise / Frost, Gary S /
    Griffin, Bruce A

    Clinical science (London, England : 1979)

    2017  Volume 131, Issue 21, Page(s) 2561–2573

    Abstract: Dietary sugars are linked to the development of non-alcoholic fatty liver disease (NAFLD) and dyslipidaemia, but it is unknown if NAFLD itself influences the effects of sugars on plasma lipoproteins. To study this further, men with NAFLD ( ...

    Abstract Dietary sugars are linked to the development of non-alcoholic fatty liver disease (NAFLD) and dyslipidaemia, but it is unknown if NAFLD itself influences the effects of sugars on plasma lipoproteins. To study this further, men with NAFLD (
    MeSH term(s) Adult ; Aged ; Cross-Over Studies ; Dietary Carbohydrates/administration & dosage ; Dietary Carbohydrates/pharmacology ; Enzyme-Linked Immunosorbent Assay ; Fasting/blood ; Fats/metabolism ; Humans ; Lipids/blood ; Lipoproteins, VLDL/blood ; Lipoproteins, VLDL/metabolism ; Liver/drug effects ; Liver/metabolism ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease/blood ; Non-alcoholic Fatty Liver Disease/metabolism ; Outcome Assessment, Health Care ; Time Factors ; Triglycerides/blood ; Triglycerides/metabolism
    Chemical Substances Dietary Carbohydrates ; Fats ; Lipids ; Lipoproteins, VLDL ; Triglycerides
    Language English
    Publishing date 2017-10-17
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 206835-7
    ISSN 1470-8736 ; 0301-0538 ; 0009-0360 ; 0143-5221
    ISSN (online) 1470-8736
    ISSN 0301-0538 ; 0009-0360 ; 0143-5221
    DOI 10.1042/CS20171208
    Database MEDical Literature Analysis and Retrieval System OnLINE

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