Chronic Fatigue Etiology in Intensive Care Unit Survivors: the Role of Neuromuscular Function

Study Overview
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Brief Summary
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Chronic fatigue is the most common and debilitating symptom in intensive care unit (ICU) survivors. Indeed, it has been widely reported that patients who stayed in ICU for prolonged periods report a feeling of tiredness for months to years after ICU discharge. This chronic fatigue affects their quality of life by decreasing their capacity to perform simple tasks of daily life. The aim of the present project is to determine whether deteriorated neuromuscular function (i.e. increased fatigability) is involved in this feeling of chronic fatigue. Because the causes of this feeling are multi-dimensional, a large battery of tests will allow us to better understand the origin of chronic fatigue. A better knowledge of chronic fatigue etiology will allow to optimize rehabilitation treatments to decrease the apparition/persistence of chronic fatigue and in fine improve life quality.

Official Title
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Chronic Fatigue Etiology in Intensive Care Unit Survivors: the Role of Neuromuscular Function

Conditions
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Muscle, Chronic Fatigue Syndrome, Intensive Care Unit

Intervention / Treatment
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* Other: Questionnaires
* Biological: blood test
* Other: Maximal effort test
* Device: actigraphy
* Device: Neuromuscular evaluation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Have been ventilated for at least 72 hours in the intensive care unit IGS2 score (severity in resuscitation) > 15 FACIT-F (Functional Assessment of Chronic Illness Therapy-Fatigue) score ≥ 36 or a score ≤ 32 intensive care unit discharge in ≥ 6 months and ≤ 5 years preceding the study Approval received from a physician Command of the French language Exclusion Criteria: Taking neuroactive substances that can alter corticospinal excitability Contraindication to the application of a magnetic field Contraindication to the practice of Magnetic Resonance Imaging Participant is pregnant Patients with psychiatric disorders Paraplegic and hemiplegic patients Addictive disorders

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Non-fatigued patients<br> | Other: Questionnaires<br>* Quality of life Depression Physical pain Social provisions Quality of sleep<br>Biological: blood test<br>* complete blood count and cytokine concentration<br>Other: Maximal effort test<br>* The maximal effort test with VO2max recordings will be assessed during the first visit to the laboratory.<br>Device: actigraphy<br>* assessment of sleep quality<br>Device: Neuromuscular evaluation<br>* The maximum isometric force produced by the knee extensors will be measured on the ergometer the intensity of muscular electrical activity recorded by surface electromyography Peripheral nerve stimulation Transcranial magnetic stimulation Magnetic resonance imaging (optional)<br>|
| Experimental: Fatigued patients<br> | Other: Questionnaires<br>* Quality of life Depression Physical pain Social provisions Quality of sleep<br>Biological: blood test<br>* complete blood count and cytokine concentration<br>Other: Maximal effort test<br>* The maximal effort test with VO2max recordings will be assessed during the first visit to the laboratory.<br>Device: actigraphy<br>* assessment of sleep quality<br>Device: Neuromuscular evaluation<br>* The maximum isometric force produced by the knee extensors will be measured on the ergometer the intensity of muscular electrical activity recorded by surface electromyography Peripheral nerve stimulation Transcranial magnetic stimulation Magnetic resonance imaging (optional)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| voluntary maximum force reduction |  | at 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neuromuscular function : cortical activity | Level of cortical activation and cortico-spinal excitability measured by transcranial magnetic stimulation | at 2 weeks | 
| Neuromuscular function : Peripheral function | Peripheral function by electrical nerve stimulation | at visit 2 | 
| Maximal oxygen uptake (VO2max) | measured by effort test | at 2 weeks | 
| quality of sleep | measured by actigraphy | at baseline | 
| Quadriceps muscle volume (optional) | with Magnetic resonance imaging | at 3 weeks | 
| muscle dysfunction (optional) | measured by a Phosphorus 31 Nuclear magnetic resonance test | at 3 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neuromuscular function