ICU-metabolism.se © 2010
Our research is dedicated to the metabolic and nutritional problems of critically ill patients treated in the ICU.
We are a small research group dedicated to the metabolic and nutritional problems of critically ill patients in the intensive care unit (ICU).
The patient treated in our general ICU has most often a medical or surgical reason for visiting the hospital. Since we have a relatively small ICU for the size of the hospital only the very sick are admitted to the unit. Most patients admitted suffer from single or multiple organ failure (MOF). MOF is a syndrome were vital organs start failing and without support in the ICU the patient would die.
These patients suffer from many metabolic and nutritional problems. One that our research group focusses on is the loss of skeletal muscle mass and function. Loss of muscle mass is quite common during disease but during critical illness this is far more dramatic then in any other situation. These patients on average loose 10% of their leg muscle protein per week during the first weeks of disease. Since most patients are sedated and have a compromised gut function, feeding these patients is a challenge. Most patients receive a combination of parenteral and enteral nutrition but underfeeding and also overfeeding are very common in the ICU.
Better control of both metabolism and nutrition have been shown to improve the patient's outcome. Both underfeeding and overfeeding are related to worst outcome. Low muscle mass has been shown to compromise outcome and recovery. Also direct control or treatment of metabolic derangements, like treating hyperglycemia with insulin, has been shown to improve the patient's outcome.
In our research we try to elucidate derangments in the metabolism of these critically ill patients and try to find the mechanisms leading to these changes. In addition we study the possibilities of the patients to utilise nutrition and if this has any effect on the metabolic derangements. The majority of out research includes real ICU patients but sometime we include surgical patients of healthy volunteers to perform proof-of-principle or mechanistic studies. Despite all research being done close to the patients we use research tools from very basic (gene expression, enzyme activities etc.) to more clinical (energy expenditure, clinical outcome etc.).
The research facilities available to the research group are a group of research nurses that help with performing the clinical studies and seeing to that we work acoording to GCP (good clinical practice) and analytical laboratory were we do most of our analyses. The laboratory also contains the Karolinska Stable Isotope Core that helps other researcher with the use of stable isotope tarcers in metabolic studies.
Funding Currently we are funded by Swedish Research Coucil (Vetenskapsrådet), Stockholm County Coucil (SLL ALF), Karolinska Institutet, Karolinska University Hospital, NIH and the European Union FP7 program. For funding opportunities look at KI's grant office HERE.
Jonathan Grip received one of the prestigious ESICM fellowships for his project on lactate kinetics in the critically ill.