Reliability of ultrasound in the assessment of muscle thickness in critically ill children.
Autor: | de Oliveira JK; Programa de Posgrado en Pediatría, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS), Brasil. Electronic address: jessicaknisspell@gmail.com., Schaan CW; Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil., Silva CK; Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil., Piva TC; Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil., Sousa ITE; Programa de Posgrado en Salud Infantil y Adolescente, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brasil., Bruno F; Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil., Lukrafka JL; Programa de Posgrado en Pediatría, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre (RS), Brasil. |
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Jazyk: | angličtina |
Zdroj: | Anales de pediatria [An Pediatr (Engl Ed)] 2023 Jun; Vol. 98 (6), pp. 411-417. Date of Electronic Publication: 2023 May 15. |
DOI: | 10.1016/j.anpede.2023.04.009 |
Abstrakt: | Introduction: Ultrasound has been used to quantify and qualify muscle morphology in critically ill children and can detect changes in muscle thickness. The aim of this study was to assess the reliability of ultrasound measurement of muscle thickness in critically ill children and to compare the assessments made by an expert with those made by inexperienced sonographers. Material and Methods: Cross-sectional observational study conducted in the paediatric intensive care unit of a tertiary care university hospital in Brazil. The sample included patients aged 1 month to 12 years who received invasive mechanical ventilation for at least 24 h. Ultrasound images of the biceps brachii/brachialis and quadriceps femoris were obtained by one experienced sonographer and several inexperienced sonographers. We assessed intrarater and inter-rater reliability by means of the intraclass correlation coefficient (ICC) and Bland-Altman plot analysis. Results: Muscle thickness was measured in 10 children with a mean age of 15.5 months. The mean thickness of the assessed muscles as 1.14 cm for the biceps brachii/brachialis (standard deviation [SD], 0.27) and 1.85 cm for the quadriceps femoris (SD, 0.61). The intrarater and inter-rater reliability were good for all sonographers (ICC > 0.81). The differences were small, there was no significant bias in the Bland-Altman plots and all measurements were within the limits of agreement, except for 1 measurement of biceps and quadriceps. Conclusion: Sonography can be used in critically ill children to accurately assess changes in muscle thickness, even by different evaluators. More studies are needed to establish a standardised approach to the use of ultrasound for monitoring muscle loss in order to incorporate it in clinical practice. (Copyright © 2023 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.) |
Databáze: | MEDLINE |
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