Can functional electrical stimulation-assisted cycle ergometry replace insulin infusion in patients? A nested substudy in a randomized controlled trial with 6 months' follow-up

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F22%3A43921742" target="_blank" >RIV/00216208:11120/22:43921742 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064173:_____/22:43921742

Výsledek na webu

<a href="https://doi.org/10.1002/jpen.2213" target="_blank" >https://doi.org/10.1002/jpen.2213</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1002/jpen.2213" target="_blank" >10.1002/jpen.2213</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Can functional electrical stimulation-assisted cycle ergometry replace insulin infusion in patients? A nested substudy in a randomized controlled trial with 6 months' follow-up

Popis výsledku v původním jazyce

BACKGROUND: Functional electrical stimulation-assisted cycle ergometry (FESCE) can deliver active exercise to critically patients including those who are sedated. Aerobic exercise is known to stimulate skeletal muscle glucose uptake. We asked whether FESCE can reduce intravenous insulin requirements and improve insulin sensitivity in intensive care patients. METHOD: We performed an a priori planned secondary analysis of data from an outcome-based randomised-controlled trial (NCT02864745) of FESCE-based early mobility programme vs. standard of care in mechanically ventilated patients. We analysed glucose profile, glucose intake and insulin requirements during ICU stay in all enrolled patients. In a nested subgroup we performed hyperinsulinemic (120 mIU.m(-2) .min(-1) ) euglycemic clamp at days 0, 7 and 180 (n = 30, 23 and 11, respectively). RESULTS: We randomised 150 patients 1:1 to receive intervention or standard of care. Seventeen (23%) patients in each study arm had a history of diabetes. During ICU stay patients received 137+-65 and 137+-88 g/day of carbohydrates (p = 0.97), and 31 vs. 35 (p = 0.62) of them required insulin infusion to maintain blood glucose 8.61+-2.82 vs. 8.73+-2.67 mM (p = 0.75, n = 11254). In those treated with insulin, median daily dose was 53 (IQR 25-95) vs. 62 (IQR 26-96) IU in the intervention and control arm, respectively (p = 0.44). In the subgroup of patients undergoing hyperglycaemic clamps, insulin sensitivities improved similarly and significantly from acute and protracted critical illness towards 6 months post discharge. CONCLUSION: Functional electrical stimulation-assisted cycle ergometry-based early mobility programme does not significantly reduce insulin requirements in critically ill patients on mechanical ventilation.

Název v anglickém jazyce

Can functional electrical stimulation-assisted cycle ergometry replace insulin infusion in patients? A nested substudy in a randomized controlled trial with 6 months' follow-up

Popis výsledku anglicky

BACKGROUND: Functional electrical stimulation-assisted cycle ergometry (FESCE) can deliver active exercise to critically patients including those who are sedated. Aerobic exercise is known to stimulate skeletal muscle glucose uptake. We asked whether FESCE can reduce intravenous insulin requirements and improve insulin sensitivity in intensive care patients. METHOD: We performed an a priori planned secondary analysis of data from an outcome-based randomised-controlled trial (NCT02864745) of FESCE-based early mobility programme vs. standard of care in mechanically ventilated patients. We analysed glucose profile, glucose intake and insulin requirements during ICU stay in all enrolled patients. In a nested subgroup we performed hyperinsulinemic (120 mIU.m(-2) .min(-1) ) euglycemic clamp at days 0, 7 and 180 (n = 30, 23 and 11, respectively). RESULTS: We randomised 150 patients 1:1 to receive intervention or standard of care. Seventeen (23%) patients in each study arm had a history of diabetes. During ICU stay patients received 137+-65 and 137+-88 g/day of carbohydrates (p = 0.97), and 31 vs. 35 (p = 0.62) of them required insulin infusion to maintain blood glucose 8.61+-2.82 vs. 8.73+-2.67 mM (p = 0.75, n = 11254). In those treated with insulin, median daily dose was 53 (IQR 25-95) vs. 62 (IQR 26-96) IU in the intervention and control arm, respectively (p = 0.44). In the subgroup of patients undergoing hyperglycaemic clamps, insulin sensitivities improved similarly and significantly from acute and protracted critical illness towards 6 months post discharge. CONCLUSION: Functional electrical stimulation-assisted cycle ergometry-based early mobility programme does not significantly reduce insulin requirements in critically ill patients on mechanical ventilation.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30221 - Critical care medicine and Emergency medicine

Projekt

<a href="/cs/project/NV16-28663A" target="_blank" >NV16-28663A: Funkční elektrickou stimulací asistovaná bicyklová ergometrie u kriticky nemocných: vztah mezi fyziologií svalu a dlouhodobým funkčním výsledkem léčby</a><br>

Návaznosti

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Rok uplatnění

2022

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Parenteral and Enteral Nutrition

ISSN

0148-6071

e-ISSN

1941-2444

Svazek periodika

46

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

5

Strana od-do

249-253

Kód UT WoS článku

000678797600001

EID výsledku v databázi Scopus

2-s2.0-85111524515