Evaluation of muscle loss by ultrasonography in critically ill patients.

Autor: Mendes JNDS; Pronto Socorro Cardiológico Universitário de Pernambuco, Departamento de Nutrição, Universidade de Pernambuco, Recife, Brazil., Rodrigues IG; Pronto Socorro Cardiológico Universitário de Pernambuco, Departamento de Nutrição, Universidade de Pernambuco, Recife, Brazil., Arcoverde GMPF; Pronto Socorro Cardiológico Universitário de Pernambuco, Departamento de Nutrição, Universidade de Pernambuco, Recife, Brazil., Floro CCP; Escola Superior de Educação Fìsica-ESEF, Programa de Pós Graduação, Universidade de Pernambuco, Recife, Brazil., Fortunato WSL; Pronto Socorro Cardiológico Universitário de Pernambuco, Departamento de Nutrição, Universidade de Pernambuco, Recife, Brazil., Lima RMDS; Pronto Socorro Cardiológico Universitário de Pernambuco, Departamento de Nutrição, Universidade de Pernambuco, Recife, Brazil., Pinho CPS; Pronto Socorro Cardiológico Universitário de Pernambuco, Departamento de Nutrição, Universidade de Pernambuco, Recife, Brazil.
Jazyk: angličtina
Zdroj: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition [Nutr Clin Pract] 2023 Jun; Vol. 38 (3), pp. 664-671. Date of Electronic Publication: 2022 Dec 25.
DOI: 10.1002/ncp.10945
Abstrakt: 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.
(© 2022 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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