Metabolic aspects of muscle wasting during critical illness

Robert J. J. van Gassel*, Michelle R. Baggerman, Marcel C. G. van de Poll

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Purpose of review Skeletal muscle wasting during critical illness is the result of disturbed metabolism. No proven effective interventions targeting skeletal muscle mass and function during critical illness currently exist. This review summarizes recent advances regarding the complexity of metabolic factors involved and the challenge of establishing the clinical effects of metabolic interventions targeting the muscle. Recent findings Although the catabolic state is limited to the acute phase of critical illness, its subsequent impact on muscle mass and function persists long after ICU discharge. Immobilization, inflammation and disturbed muscle energy and nutrient metabolism are key drivers of muscle protein loss. Current research focuses on the effects of enhanced protein provision, specific substrate delivery and physical exercise. Whilst some interventions have been successful at improving muscle mass, these effects do not always carry over into muscle function or strength. Increased understanding of metabolic derangements during critical illness provides new potential targets for treatment. The potential of dietary protein to attenuate the muscle protein catabolic state has yet to be established in clinical trials. Basic research should focus on ways to further improve the anabolic potential of nutrition by unravelling mechanisms that regulate anabolic and catabolic pathways and energy metabolism.

Original languageEnglish
Pages (from-to)96-101
Number of pages6
JournalCurrent Opinion in Clinical Nutrition and Metabolic Care
Issue number2
Publication statusPublished - Mar 2020


  • dietary protein
  • exercise
  • metabolism
  • muscle
  • CARE


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