Abstract
Background
Activin A is a potent negative regulator of muscle mass elevated in critical illness.
It is unclear whether muscle strength and physical function in critically ill humans
are associated with elevated activin A levels.
Objectives
The objective of this study was to investigate the relationship between serum activin
A levels, muscle strength, and physical function at discharge from the intensive care
unit (ICU) and hospital.
Methods
Thirty-six participants were recruited from two tertiary ICUs in Melbourne, Australia.
Participants were included if they were mechanically ventilated for >48 h and expected
to have a total ICU stay of >5 days. The primary outcome measure was the Six-Minute
Walk Test distance at hospital discharge. Secondary outcome measures included handgrip
strength, Medical Research Council Sum Score, Physical Function ICU Test Scored, Six-Minute
Walk Test, and Timed Up and Go Test assessed throughout the hospital admission. Total
serum activin A levels were measured daily in the ICU.
Results
High peak activin A was associated with worse Six-Minute Walk Test distance at hospital
discharge (linear regression coefficient, 95% confidence interval, p-value: −91.3, −154.2
to −28.4, p = 0.007, respectively). Peak activin A concentration was not associated with the
secondary outcome measures.
Conclusions
Higher peak activin A may be associated with the functional decline of critically
ill patients. Further research is indicated to examine its potential as a therapeutic
target and a prospective predictor for muscle wasting in critical illness.
Study registration
ACTRN12615000047594.
Keywords
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Article info
Publication history
Published online: December 12, 2022
Accepted:
October 31,
2022
Received in revised form:
October 24,
2022
Received:
June 15,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
