Selina M Parry1, Doa El-Ansary2, Michael S Cartwright3, Aarti Sarwal3, Sue Berney4, René Koopman5, Raquel Annoni6, Zudin Puthucheary7, Ian R Gordon8, Peter E Morris9, Linda Denehy2. 1. Department of Physiotherapy, The University of Melbourne, Victoria, Australia. Electronic address: selina.parry@unimelb.edu.au. 2. Department of Physiotherapy, The University of Melbourne, Victoria, Australia. 3. Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA. 4. Department of Physiotherapy, Austin Health, Melbourne, Australia. 5. Department of Physiology, The University of Melbourne, Victoria, Australia. 6. Department of Physiotherapy, The University of Melbourne, Victoria, Australia; CAPES Foundation, Ministry of Education of Brazil, Brasília, DF, Brazil. 7. Division of Respiratory and Critical Care Medicine, National University Health System, Singapore. 8. Statistical Consulting Centre, The University of Melbourne, Victoria, Australia. 9. Department of Pulmonology and Critical Care, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Abstract
PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Authors: Kitty S Chan; Marina Mourtzakis; Lisa Aronson Friedman; Victor D Dinglas; Catherine L Hough; E Wesley Ely; Peter E Morris; Ramona O Hopkins; Dale M Needham Journal: Crit Care Med Date: 2018-08 Impact factor: 7.598
Authors: Jessica A Palakshappa; John P Reilly; William D Schweickert; Brian J Anderson; Viviane Khoury; Michael G Shashaty; David Fitzgerald; Caitlin Forker; Kelly Butler; Caroline A Ittner; Rui Feng; D Clark Files; Michael P Bonk; Jason D Christie; Nuala J Meyer Journal: J Crit Care Date: 2018-10 Impact factor: 3.425