Quantitative neuromuscular ultrasound in intensive care unit-acquired weakness: A systematic review.
Quantitative neuromuscular ultrasound in intensive care unit-acquired weakness: A systematic review.
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DOI：
10.1002/mus.24728
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发表时间：
2015-11
期刊：
影响因子：
3.4
通讯作者：
Hough CL
中科院分区：
文献类型：
--
作者：
Bunnell A;Ney J;Gellhorn A;Hough CL
重症监护病房获得性虚弱(ICU-AW)在危重病患者中造成显著的发病率和损伤。神经肌肉超声(NMUS)的最新进展可以在危重疾病的早期评估神经肌肉病理。现就超声在ICU-AW中的应用作一综述。在Medline索引的文章中搜索与超声波和危重疾病相关的术语。两位评价者评价了由此产生的摘要(n=218)，并完成了全文审查(n=13)。纳入12篇研究和1例病例报告。10项研究评估了肌肉厚度或横截面积(CSA)；8项报告减少，2项报告无变化。两项研究报告了神经肌肉电刺激对肌肉厚度的保留，1项研究没有发现保存。一项研究发现，灰度级标准差有所下降，但回声能力没有变化。一项研究描述了回声和束状物的增加。超声在ICU-AW中的可靠性尚未完全确定。需要进一步的研究来确定能够可靠地预测ICU-AW的临床、电诊断和病理结果的超声指标。
Intensive care unit acquired weakness (ICU-AW) causes significant morbidity and impairment in critically ill patients. Recent advances in neuromuscular ultrasound (NMUS) allow evaluation of neuromuscular pathology early in critical illness. We review application of ultrasound in ICU-AW. MEDLINE-indexed articles were searched for terms relevant to ultrasound and critical illness. Two reviewers evaluated the resulting abstracts (n=218) and completed full-text review (n=13). Twelve studies and 1 case report were included. Ten studies evaluated muscle thickness or cross sectional area (CSA); 8 reported decrease, and 2 reported no change. Two studies reported preservation of muscle thickness in response to neuromuscular electrical stimulation, and 1 found no preservation. One study found decreases in gray-scale standard deviation, but no change in echogenicity. One study described increases in echogenicity and fasciculations. Ultrasound reliability in ICU-AW is not fully established. Further investigation is needed to identify ultrasound measures which reliably predict clinical, electrodiagnostic, and pathologic findings of ICU-AW.