Point-of-Care Ultrasound to Evaluate Thickness of Rectus Femoris, Vastus Intermedius Muscle, and Fat as an Indicator of Muscle and Fat Wasting in Critically Ill Patients in a Multidisciplinary Intensive Care Unit
Point-of-Care Ultrasound to Evaluate Thickness of Rectus Femoris, Vastus Intermedius Muscle, and Fat as an Indicator of Muscle and Fat Wasting in Critically Ill Patients in a Multidisciplinary Intensive Care Unit
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DOI：
10.4103/ijccm.ijccm_394_18
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发表时间：
2018-11-01
影响因子：
2
通讯作者：
Hiremathada, Sahajananda
中科院分区：
文献类型：
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作者：
Katari, Yeshaswini;Srinivasan, Rangalakshmi;Hiremathada, Sahajananda
背景：肌萎缩是ICUAW患者的普遍特征。下肢的肌肉更容易出现早期萎缩。脂肪厚度的测量用于评估营养不良。本研究旨在评价皮下脂肪是否也随肌肉厚度沿着减少，以及是否可以可靠地用作使用床旁超声进行重症患者营养评估的指标。材料和方法：对100例入住多学科重症监护病房（ICU）的患者进行观察性临床研究。在入住ICU的第1、3和7天测量总大腿前厚度、股直肌厚度、脂肪厚度以及股中间肌和股直肌的联合厚度。结果：从第1天到第7天，肌肉质量逐渐减少。肌肉损失不仅限于股直肌，而且股中间肌也显示出显著的减少，如骨骼肌肉测量所示。包括肌肉和脂肪区室的皮肤到骨骼的测量显示出下降。结论：超声在早期发现和预防ICUAW的可能纠正措施方面具有潜在的实用性。与第1天相比，第3天、第7天的股直肌厚度、皮肤-骨厚度和骨-肌肉厚度显示出统计学显著差异。脂肪层未显示统计学显著降低。
Background: Muscular atrophy is the universal feature in patients with ICUAW. Muscles of the lower limb are more prone to early atrophy. Measurement of fat thickness is used to assess malnutrition. This study was designed to evaluate if, subcutaneous fat also reduces along with muscle thickness and if it can be reliably used as an indicator of nutritional assessment in critically ill patients using point of care ultrasound. Materials and Methods: An observational clinical study of 100 patients admitted to multidisciplinary intensive care units (ICUs). Total anterior thigh thickness, thickness of the rectus femoris muscle, fat thickness, and the combined thickness of vastus intermedius and rectus femoris were taken on day 1, 3, and 7 of ICU admission. Results: There was progressive loss of muscle mass from day 1 to day 7. Muscle loss was not only limited to rectus femoris, but vastus intennedius also showed a significant decrease as indicated by the bone to muscle measurement. Skin to bone measurement which includes both muscle and fat compartment showed a decline. Conclusions: There is potential utility of ultrasound for early detection and probable corrective measures to prevent ICUAW. The rectus femoris thickness, skin to bone, and bone to muscle thickness show statistically significant difference on day 3, day 7 compared to day 1. Fat layer did not show statistically significant decrease.