Effect of early exercise on inflammation regulation in critical ill patients

Abstract

 Increased inflammatory state during critical illness exposed patients to neuromuscular damages related to bed rest. Skeletal muscle proteolytic pathways are activated by several factors including pro-inflammatory cytokines.

Large amount of evidence exists supporting the benefices of exercise on healthy subjects and those with low-grade chronic inflammation. Showing a decline of pro-inflammatory and increase of anti-inflammatory cytokines. 

Evidences are scarce in the critically ill setting and based on low intensity interventions. Some authors stated that early exercise during systemic inflammation could worsen skeletal muscle damages. However, recent evidences on early exercise in ICU even during severe sepsis, showed no detrimental effects on inflammation. Other data suggest a better control of inflammation by low intensity interventions in critically ill patients.

Despite the lack of evidence, current data supports the potential benefit of early exercise in critically ill patients, limiting muscle wasting and controlling the ongoing inflammation.