Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul;48(5):615-623.
doi: 10.1002/jpen.2627. Epub 2024 Mar 30.

Association between protein intake and muscle wasting in critically ill children: A prospective cohort study

Lyvonne N Tume  1   2 , Christopher Simons  2 , Lynne Latten  2   3 , Chao Huang  4 , Paul Comfort  5 , Vanessa Compton  2 , Anand Wagh  2 , Archie Veale  6 , Frederic V Valla  7
Affiliations

Association between protein intake and muscle wasting in critically ill children: A prospective cohort study

Lyvonne N Tume et al. JPEN J Parenter Enteral Nutr. 2024 Jul.

Abstract

Background: Survival from pediatric critical illness in high-income countries is high, and the focus now must be on optimizing the recovery of survivors. Muscle mass wasting during critical illness is problematic, so identifying factors that may reduce this is important. Therefore, the aim of this study was to examine the relationship between quadricep muscle mass wasting (assessed by ultrasound), with protein and energy intake during and after pediatric critical illness.

Methods: A prospective cohort study in a mixed cardiac and general pediatric intensive care unit in England, United Kingdom. Serial ultrasound measurements were undertaken at day 1, 3, 5, 7, and 10.

Results: Thirty-four children (median age 6.65 [0.47-57.5] months) were included, and all showed a reduction in quadricep muscle thickness during critical care admission, with a mean muscle wasting of 7.75%. The 11 children followed-up had all recovered their baseline muscle thickness by 3 months after intensive care discharge. This muscle mass wasting was not related to protein (P = 0.53, ρ = 0.019) (95% CI: -0.011 to 0.049) or energy intake (P = 0.138, ρ = 0.375 95% CI: -0.144 to 0.732) by 72 h after admission, nor with severity of illness, highest C-reactive protein, or exposure to intravenous steroids. Children exposed to neuromuscular blocking drugs exhibited 7.2% (95% CI: -0.13% to 14.54%) worse muscle mass wasting, but this was not statistically significant (P = 0.063).

Conclusion: Our study did not find any association between protein or energy intake at 72 h and quadricep muscle mass wasting.

Keywords: child; intensive care; muscle mass; neonate; nutrition.

PubMed Disclaimer

References

REFERENCES

    1. Paediatric Intensive Care Audit Network (PICANet) Annual Report 2016‐2018. Accessed April 27, 2020. https://www.picanet.org.uk/annual-reporting-and-publications/
    1. Puthucheary ZA, Rawal J, McPhail M, et al. Acute skeletal muscle wasting in critical illness. JAMA. 2013;310(15):1591‐1600.
    1. Johnson RW, Ng KWP, Dietz AR, et al. Muscle atrophy in mechanically‐ventilated critically ill children. PLoS One. 2018;13(12):e0207720. doi:10.1371/journal.pone.0207720
    1. Williams S, Horrocks IA, Ouvrier RA, Gillis J, Ryan MM. Critical illness polyneuropathy and myopathy in pediatric intensive care: a review. Pediatr Crit Care Med. 2007;8(1):18‐22.
    1. Valla FV, Young DK, Rabilloud M, et al. Thigh ultrasound monitoring identifies decreases in quadriceps femoris thickness as a frequent observation in critically ill children. Pediatr Crit Care Med. 2017;18(8):e339‐e347.

Substances