Elsevier

Critical Care Clinics

Volume 35, Issue 2, April 2019, Pages 301-313
Critical Care Clinics

Osteoporosis and the Critically Ill Patient

https://doi.org/10.1016/j.ccc.2018.11.006Get rights and content

Section snippets

Key points

  • •

    Improved survival after critical illness has led to recognition of impaired recovery following critical illness as a major public health problem.

  • •

    A consistent association between critical illness and accelerated bone loss has been described, including changes in bone turnover markers, bone mineral density, and fragility fracture rate.

  • •

    The exact role of biochemical changes to bone; changes to osteoclast and osteoblast number, maturation, and activity; and relative contributions of humoral and

Summary

More is understood about critical illness–associated bone loss than was did a decade ago. There is increasing and consistent evidence of abnormal bone metabolism during critical illness, with a pattern of early increased bone resorption and suppression of bone formation that persists for up to a month, and changes to normal bone resorption and increased formation over the subsequent year. There is evidence of skeletal impact from the increased bone turnover associated with critical illness,

Acknowledgments

Research contributing to this paper was supported by an unrestricted grant from the Intensive Care Foundation https://www.intensivecarefoundation.org.au.

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