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Improved Muscle Metabolism by Combination of Muscle Activation and Protein Substitution ( IMEMPRO )
Sponsor: Technical University of Munich
Summary
Intensive Care Unit Acquired Weakness (ICUAW) describes muscle weakness that occurs in around 40% of patients during an intensive care stay. The morbidity and mortality of these patients is significantly increased over a 5-year period. The aim of this study is to investigate the combined effect of early enteral high-protein nutrition and early muscle activation on muscle atrophy in critically ill patients. The study will include 40 patients (20 intervention, 20 observation) with requirement for enteral nutrition at time of inclusion. In the intervention group the maximum possible level of mobilization is carried out and muscles are activated twice a day using neuromuscular electrical stimulation (NMES). The nutrition plan of the intervention group is based on the applicable guidelines for intensive care medicine with exception of increased protein intake. The control group receives therapy without deviating from the standard according of the DGEM guideline. The study aims to show that the decrease in muscle mass is significantly less than in the control group (primary hypothesis) via ultrasound of the rectus femoris muscle and in case of given consent muscle biopsy. As secondary hypothesis it is examined whether the combination of early high protein intake and muscle activation improves muscle strength and endurance.
Official title: Improved Muscle Metabolism by Combination of Muscle Activation and Protein Substitution: a Randomized, Outcome-assessor Blinded, Proof-of-concept Study (IMEMPRO)
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
40
Start Date
2023-06-27
Completion Date
2027-01-31
Last Updated
2026-03-03
Healthy Volunteers
No
Conditions
Interventions
Dietary Supplement: additional substitution of protein
Day one (admission) no nutrition is applied. Protein target is increased as follows: * to a level of 1,2g/kg/d on day 1 after ICU admission * to a level of 1,4g/kg/d on day 2 after ICU admission * to a level of 1,6g/kg/d on day 3 after ICU admission * to a level of 1,8g/kg/d on day 4 after ICU admission * to a level of 2,0g/kg/d from day 5 onwoards Additional protein is given within 2 hours after mobilization respectively: * to 0,125g/kg/d on day 1 after ICU admission * to 0,2g/kg/d on day 2 after ICU admission * to 0,25g/kg/d on day 3 after ICU admission * to 0,3g/kg/d from day 4 after ICU admission onwoards
Neuromuscular electrical stimulation
twice daily 60 minutes till day 28 or ICU discharge
Early Mobilization
at least 20 minutes a day following the SOMS concept. Duration: till 28 day or ICU discharge
Locations (4)
Medical University of Vienna
Vienna, Vienna, Austria
Klinikum rechts der Isar, School of Medicine, Technical Universtity of Munich
Munich, Bavaria, Germany
Charité - Universitätsmedizin Berlin
Berlin, State of Berlin, Germany
Universitätsklinikum Ulm
Ulm, Germany