Evaluation of muscle loss by ultrasonography in critically ill patients

Abstract

Background: Critically ill patients have intense muscle tissue mobilization, and attenuating protein catabolism may contribute to improved outcomes.Objective: To evaluate short-term muscle loss in critically ill patients. Methods:In this prospective observational study, we evaluated the thickness of the rectus femoris muscle by ultrasonography in young and older adults of both sexes admitted to a cardiological intensive care unit within 48 h of admission (baseline) and after 7 days. The results were compared and correlated with anthropometric, clinical, and biochemical parameters. The significance level for all statistical analyses was 0.05. Results:The final sample comprised 88 patients with a mean age of 66.2 ± 11.8 years. There was an average 13.5% reduction in rectus femoris muscle thickness over the study period (P < 0.001), regardless of the thigh circumference maintenance (P = 0.229). This reduction occurred even with improved clinical parameters (C-reactive protein, Simplified Acute Physiology Score) and was greater in patients receiving mechanical ventilation and sedation and in those who died. Regarding nutrition status, malnourished and eutrophic individuals showed greater muscle loss than overweight individuals. There was also an inverse correlation of muscle loss (percentage) with body mass index, arm circumference, and calf circumference (P < 0.05), demonstrating that the lower these anthropometric measurements, the higher the muscle loss obtained by ultrasound. Conclusion: Ultrasonography assessment detected muscle mass loss in the short-term more sensitively than the anthropometric method. However, it demands caution and further studies demonstrating this analysis.

The Associations between Muscle Ultrasound Measurements, Calf Circumference, Mid-upper Arm Circumference, and Body Mass Index

“…[5] In a study conducted in critical care, rectus femoris muscle thickness measured by US detected the loss of muscle mass in a short time more sensitively than the anthropometric measurements. [34] In our study, although the higher BMI, the higher MAC, CC, WC, and HC, we did not observe the same relationship with HGS, RF muscle thickness, and RF cross-sectional area. Therefore, ın multivariate analysis, we presented the independent association of RF muscle thickness, RF cross-sectional area, and GC muscle thickness with HGS.…”

Survival outcomes and mobilization during venovenous extracorporeal membrane oxygenation: a retrospective cohort study

“…In heathy individuals, 6 weeks of bed rest results in 30% loss of muscle strength due to inactivity ( 7 ). In context of sedation, relaxation, or katabolic conditions typical to severe pulmonary failure, the muscle loss is much more pronounced ( 8 ). In critically ill patients, the incidence of ICU-acquired weakness is reported roughly in 40% ( 9 ) and is associated with adverse outcome including a prolonged hospitalization, impaired weaning and increased risk of death ( 10 ).…”

O uso do ultrassom na avaliação de massa magra e previsão de desfechos clínicos em pacientes críticos

“…Destes, 7 não avaliaram associação com desfechos clínicos, 4 foram realizados com pacientes não críticos e 2 avaliaram apenas o músculo do diafragma. Dessa forma, a amostra foi composta por 15 artigos (ER et al, 2021(ER et al, , 2023GRUTHER et al, 2008;HRDY et al, 2023;LEE et al, 2021;MAGALHÃES et al, 2020;MAYER et al, 2020;MENDES et al, 2023;PARRY et al, 2015;PASSOS;MACEDO;DE-SOUZA, 2021;PUTHUCHEARY et al, 2013;TANAKA;YAMADA, 2021;TOLEDO et al, 2021;UMBRELLO et al, 2021;YANAGI et al, 2021).…”