Trial reportPloS one2019
Exploration of muscle loss and metabolic state during prolonged critical illness: Implications for intervention?
Trial report in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06168136 (Effects of Medical High Protein Nutrition on the Muscle Mass in Adult ICU Patients), which is not on this map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Medical High Protein Nutrition on the Muscle Mass in Adult ICU Patients
Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Interplay between frailty and cardiometabolic disorders: from pathophysiology to clinical implications.Cardiovascular diabetology · 2025Pooled it
- The urea-to-creatinine ratio as an emerging biomarker in critical care: a scoping review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Pooled it
- The rate and assessment of muscle wasting during critical illness: a systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Impact of high-protein enteral nutrition on muscle preservation in mechanically ventilated patients with severe pneumonia: a randomized controlled trial.Journal of health, population, and nutrition · 2024Trial
- Inflammation Course and Skeletal Muscle Wasting Correlation During the First Week in ICU: A New Approach for Personalised Feeding of Critically Ill Patients?Journal of personalized medicine · 2026Article
- Ultrasound monitoring of skeletal muscle wasting and relation to nutritional intervention in critically ill patients: MUScleNut study.Intensive care medicine experimental · 2025Article
- Respiratory and limb muscles' ability to repeatedly generate maximal isometric strength in patients with intensive care unit-acquired weakness: an observational study.BMC anesthesiology · 2025Observational
- Methodologies and clinical applications of lower limb muscle ultrasound in critically ill patients: a systematic review and meta-analysis.Annals of intensive care · 2024Review
- Bioimpedance-assessed muscle wasting and its relation to nutritional intake during the first week of ICU: a pre-planned secondary analysis of Nutriti Study.Annals of intensive care · 2024Article
- Assessment of quadriceps muscle mass by ultrasound in the postoperative period of cardiac surgery.The ultrasound journal · 2024Article
- Causality of Blood Metabolites on Proliferative Diabetic Retinopathy: Insights From a Genetic Perspective.Journal of diabetes research · 2024Article
- Enteral Feeding in Patients With Open Abdomen and Negative Pressure Therapy: A Propensity Score Analysis.Journal of abdominal wall surgery : JAWS · 2024Article
- Ultrasonographic Features of Muscular Weakness and Muscle Wasting in Critically Ill Patients.Journal of clinical medicine · 2023Review
- Association of SOFA Score with Severity of Muscle Wasting in Critically Ill Patients: A Prospective Observational Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Serum metabolomic signatures of fatty acid oxidation defects differentiate host-response subphenotypes of acute respiratory distress syndrome.Respiratory research · 2023Article
- Article
- Article
- Risk Factors of Decreased Abdominal Expiratory Muscle Thickness in Mechanically Ventilated Critically Ill Patients-The mNUTRIC Score is an Independent Predictor.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2023Article
- Association of nitrogen balance trajectories with clinical outcomes in critically ill COVID-19 patients: A retrospective cohort study.Clinical nutrition (Edinburgh, Scotland) · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundMuscle wasting in the critically ill is up to 2% per day and delays patient recovery and rehabilitation. It is linked to inflammation, organ failure and severity of illness. The aims of this study were to understand the relationship between muscle depth loss, and nutritional and inflammatory markers during prolonged critical illness. Secondly, to identify when during critical illness catabolism might decrease, such that targeted nutritional strategies may logically be initiated.
methodsThis study was conducted in adult intensive care units in two large teaching hospitals. Patients anticipated to be ventilated for >48 hours were included. Serum C-reactive protein (mg/L), urinary urea (mmol/24h), 3-methylhistidine (μmol/24h) and nitrogen balance (g/24h) were measured on days 1, 3, 7 and 14 of the study. Muscle depth (cm) on ultrasound were measured on the same days over the bicep (bicep and brachialis muscle), forearm (flexor compartment of muscle) and thigh (rectus femoris and vastus intermedius).
resultsSeventy-eight critically ill patients were included with mean age of 59 years (SD: 16) and median Intensive care unit (ICU) length of stay of 10 days (IQR: 6-16). Starting muscle depth, 8.5cm (SD: 3.2) to end muscle depth, 6.8cm (SD: 2.2) were on average significantly different over 14 days, with mean difference -1.67cm (95%CI: -2.3 to -1cm), p<0.0001. Protein breakdown and inflammation continued over 14 days of the study.
conclusionOur patients demonstrated a continuous muscle depth loss and negative nitrogen balance over the 14 days of the study. Catabolism remained dominant throughout the study period. No obvious 'nutritional tipping point" to identify anabolism or recovery could be identified in our cohort. Our ICU patient cohort is one with a moderately prolonged stay. This group showed little consistency in data, reflecting the individuality of both disease and response. The data are consistent with a conclusion that a time based assumption of a tipping point does not exist.
trial registrationInternational Standard Randomised Controlled Trial Number: ISRCTN79066838. Registration 25 July 2012.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.