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Title: Ultrasonography in the intensive care setting can be used to detect changes in the quality and quantity of muscle and is related to muscle strength and function.
Austin Authors: Parry, Selina M;El-Ansary, Doa;Cartwright, Michael S;Sarwal, Aarti;Berney, Susan C ;Koopman, René;Annoni, Raquel;Puthucheary, Zudin;Gordon, Ian R;Morris, Peter E;Denehy, Linda
Affiliation: Department of Physiotherapy, The University of Melbourne, Victoria, Australia
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
Department of Physiotherapy, Austin Health, Heidelberg, Victoria, Australia
CAPES Foundation, Ministry of Education of Brazil, Brasília, DF, Brazil
Division of Respiratory and Critical Care Medicine, National University Health System, Singapore
Statistical Consulting Centre, The University of Melbourne, Victoria, Australia
Department of Pulmonology and Critical Care, Wake Forest School of Medicine, Winston-Salem, NC, USA
Issue Date: Oct-2015
Date: 2015-06-03
Publication information: Journal of Critical Care 2015; 30(5): 1151.e9-14
Abstract: This study aimed to (1) document patterns of quadriceps muscle wasting in the first 10 days of admission and (2) determine the relationship between muscle ultrasonography and volitional measures. Twenty-two adults ventilated for more than 48 hours were included. Sequential quadriceps ultrasound images were obtained over the first 10 days and at awakening and intensive care unit (ICU) discharge. Muscle strength and function were assessed at awakening and ICU discharge. A total of 416 images were analyzed. There was a 30% reduction in vastus intermedius (VI) thickness, rectus femoris (RF) thickness, and cross-sectional area within 10 days of admission. Muscle echogenicity scores increased for both RF and VI muscles by +12.7% and +25.5%, respectively (suggesting deterioration in muscle quality). There was a strong association between function and VI thickness (r = 0.82) and echogenicity (r = -0.77). There was a moderate association between function and RF cross-sectional area (r = 0.71). Muscle wasting occurs rapidly in the ICU setting. Ultrasonography is a useful surrogate measure for identifying future impairment. Vastus intermedius may be an important muscle to monitor in the future because it demonstrated the greatest change in muscle quality and had the strongest relationship to volitional measures.
DOI: 10.1016/j.jcrc.2015.05.024
Journal: Journal of Critical Care
PubMed URL: 26211979
Type: Journal Article
Subjects: Critical illness
Intensive care
Intensive care unit–acquired weakness
Muscle wasting
Appears in Collections:Journal articles

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