Bedside ultrasound is a practical and reliable measurement tool for assessing quadriceps muscle layer thickness.
Bedside ultrasound is a practical and reliable measurement tool for assessing quadriceps muscle layer thickness.
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DOI：
10.1177/0148607113501327
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发表时间：
2014-09
期刊：
影响因子：
--
通讯作者：
Heyland DK
中科院分区：
文献类型：
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作者：
Tillquist M;Kutsogiannis DJ;Wischmeyer PE;Kummerlen C;Leung R;Stollery D;Karvellas CJ;Preiser JC;Bird N;Kozar R;Heyland DK
重症患者通常会出现骨骼肌萎缩，这可能会预测临床结果。超声是一种非侵入性方法，可以在床边测量肌肉四头肌肌层厚度（QMLT）和随后的瘦体重（LBM）。然而，目前这些测量的可靠性是未知的。本研究的目的是评估使用床旁超声测量QMLT的内部和相互可靠性。在7个中心对健康志愿者进行了QMLT的超声测量。指导培训者对每位患者进行两次测量，然后第二名培训者重复测量。组内信度衡量的是同一个人根据组内相关性（ICC）对受试者进行测量的一致性。根据ICC，评估者间的可靠性衡量了培训师和受训者在测量同一主题时的一致性。我们收集了42对操作员内部测量值（ICC为0.98）和78对培训师对受训者测量值（ICC为0.95）。培训师和受训者的结果之间没有统计学显著差异（培训师和受训者平均值=-0.028 cm，95% CI =-0.067至0.011，P = 0.1607）。当由一系列先前没有超声经验的提供者（包括营养师、护士、医生和研究助理）进行超声测量时，观察到健康志愿者QMLT的良好的评价者内和评价者间可靠性。这项技术显示出作为一种方法来评估LBM状态在ICU或医院设置和作为一种方法来评估营养和运动为基础的干预措施对肌肉萎缩的影响的承诺。
Critically ill patients commonly experience skeletal muscle wasting that may predict clinical outcome. Ultrasound is a noninvasive method that can measure muscle quadriceps muscle layer thickness (QMLT) and subsequently lean body mass (LBM) at the bedside. However, currently the reliability of these measurements are unknown. The objectives of this study were to evaluate the intra- and interreliability of measuring QMLT using bedside ultrasound. Ultrasound measurements of QMLT were conducted at 7 centers on healthy volunteers. Trainers were instructed to perform measurements twice on each patient, and then a second trainee repeated the measurement. Intrarater reliability measured how consistently the same person measured the subject according to intraclass correlation (ICC). Interrater reliability measured how consistently trainer and trainee agreed when measuring the same subject according to the ICC. We collected 42 pairs of within operator measurements with an ICC of .98 and 78 pairs of trainer-to-trainee measurements with an ICC of .95. There were no statistically significant differences between the trainer and trainee results (trainer and trainee mean = −0.028 cm, 95% CI = −0.067 to −0.011, P = .1607). Excellent intra- and interrater reliability for ultrasound measurements of QMLT in healthy volunteers was observed when performed by a range of providers with no prior ultrasound experience, including dietitians, nurses, physicians, and research assistants. This technique shows promise as a method to evaluate LBM status in ICU or hospital settings and as a method to assess the effects of nutrition and exercise-based interventions on muscle wasting.