Arnaldo Lopez-Ruiz1, Kianoush Kashani2,3. 1. Division of Critical Care, AdventHealth Medical Group, AdventHealth Orlando, Florida. 2. Division of Nephrology and Hypertension. 3. Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Abstract
PURPOSE OF REVIEW: Sarcopenia is a progressive generalized decline in skeletal muscle mass, strength, and function. This condition is highly prevalent in critically ill patients and is associated with poor outcomes in the ICU. In this review, we describe the use, evidence, and limitations of the most common validated imaging studies used to assess muscle mass in ICU, and we provide an overview of the benefits of using the sarcopenia index [(serum creatinine/serum cystatin C) × 100]) in the ICU. RECENT FINDINGS: Currently, the determination of muscle mass using anthropometric measurements and serum biomarkers is unreliable. Several new techniques, including a dual-energy X-ray absorptiometry, computed tomography scan, ultrasonography, and bioimpedance analysis, have been studied and validated for the diagnosis and prognosis of sarcopenia in the ICU. However, these techniques are often not accessible for the majority of critically ill patients. The sarcopenia index constitutes an accurate method to diagnose sarcopenia, predict ICU outcomes, and nutritional status in critically ill patients. SUMMARY: Diagnosis of sarcopenia has substantial implications in ICU patients. Choosing the correct test to identify patients who may need preventive or therapeutic support for this condition will favorably impact ICU outcomes.
PURPOSE OF REVIEW: Sarcopenia is a progressive generalized decline in skeletal muscle mass, strength, and function. This condition is highly prevalent in critically illpatients and is associated with poor outcomes in the ICU. In this review, we describe the use, evidence, and limitations of the most common validated imaging studies used to assess muscle mass in ICU, and we provide an overview of the benefits of using the sarcopenia index [(serum creatinine/serum cystatin C) × 100]) in the ICU. RECENT FINDINGS: Currently, the determination of muscle mass using anthropometric measurements and serum biomarkers is unreliable. Several new techniques, including a dual-energy X-ray absorptiometry, computed tomography scan, ultrasonography, and bioimpedance analysis, have been studied and validated for the diagnosis and prognosis of sarcopenia in the ICU. However, these techniques are often not accessible for the majority of critically illpatients. The sarcopenia index constitutes an accurate method to diagnose sarcopenia, predict ICU outcomes, and nutritional status in critically illpatients. SUMMARY: Diagnosis of sarcopenia has substantial implications in ICU patients. Choosing the correct test to identify patients who may need preventive or therapeutic support for this condition will favorably impact ICU outcomes.