Ultrasonography in the intensive care setting can be used to detect changes in the quality and quantity of muscle and is related to muscle strength and function
Ultrasonography in the intensive care setting can be used to detect changes in the quality and quantity of muscle and is related to muscle strength and function
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DOI：
10.1016/j.jcrc.2015.05.024
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发表时间：
2015-10-01
影响因子：
3.7
通讯作者：
Denehy, Linda
中科院分区：
文献类型：
--
作者：
Parry, Selina M.;El-Ansary, Doa;Denehy, Linda
目的：本研究旨在 (1) 记录入院前 10 天内股四头肌肌肉萎缩的模式，以及 (2) 确定肌肉超声检查与意志测量之间的关系。材料和方法：包括 22 名通气时间超过 48 小时的成年人。在头 10 天内以及醒来和出院时获得连续的股四头肌超声图像。在醒来和出院 ICU 时评估肌肉力量和功能。结果：总共分析了 416 张图像。入院 10 天内，股中肌 (VI) 厚度、股直肌 (RF) 厚度和横截面积减少了 30%。 RF 和 VI 肌肉的肌肉回声评分分别增加了 + 12.7% 和 + 25.5%（表明肌肉质量恶化）。功能与 VI 厚度 (r = 0.82) 和回声性 (r = -0.77) 之间存在很强的相关性。功能和 RF 横截面积之间存在中度相关性 (r = 0.71)。结论：在 ICU 环境中，肌肉萎缩会迅速发生。超声检查是识别未来损伤的有用替代措施。股中间肌可能是未来需要监测的重要肌肉，因为它表现出肌肉质量的最大变化，并且与意志测量的关系最强。 (C) 2015 Elsevier Inc. 保留所有权利。
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. (C) 2015 Elsevier Inc. All rights reserved.