Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Nemcare Hospitals Pvt. Ltd., Guwahati, Assam, India.
J Ultrasound. 2023 Sep;26(3):653-661. doi: 10.1007/s40477-022-00703-1. Epub 2022 Jul 25.
Skeletal muscle ultrasound is a valuable tool for assessing muscle wasting in ICU. Previous studies on skeletal muscle ultrasound in ICU have been performed on lower limb muscles. The current study is formulated to assess the feasibility and reliability of anterior temporalis (AT) muscle ultrasound for measuring muscle wasting in ICU.
In this prospective cohort study in 48 critically ill patients with sepsis, muscle layer thicknesses (MLTs) and mean grayscale (GS) values of anterior temporalis muscles and quadriceps femoris (Q) were measured at baseline and serially till 7 days. Correlation was made between baseline and change in MLT and GS values of AT and Q muscle and these parameters were compared between ICU survivors and non survivors.
Baseline anterior temporalis MLTs or their longitudinal changes over 7 days did not correlate significantly with the corresponding parameters of quadriceps femoris muscles. The baseline GS values of two muscle groups correlated weakly at baseline, but the change in GS over 7 days showed no correlation. The baseline MLTs of both muscle groups and their longitudinal change over 7 days did not correlate with ICU length of stay. The change in MLT of AT over 7 days was significantly greater in ICU non-survivors compared to survivors.
Measurement of ultrasonographic muscle layer thickness and grayscale parameters of anterior temporalis muscle did not show good correlation with that of quadriceps muscle.
骨骼肌超声是评估 ICU 肌肉减少症的一种有价值的工具。之前在 ICU 进行的骨骼肌超声研究都是针对下肢肌肉进行的。本研究旨在评估前颞肌（AT）超声测量 ICU 肌肉减少症的可行性和可靠性。
在这项对 48 例脓毒症危重患者的前瞻性队列研究中，在基线和 7 天内连续测量前颞肌和股四头肌的肌肉层厚度（MLT）和平均灰度（GS）值。比较 AT 和 Q 肌肉的基线和 MLT 及 GS 值变化之间的相关性，并比较 ICU 幸存者和非幸存者之间的这些参数。
基线前颞肌 MLTs 或其 7 天内的纵向变化与股四头肌相应参数无显著相关性。两组肌肉的基线 GS 值在基线时弱相关，但 7 天内的 GS 值变化无相关性。两组肌肉的基线 MLTs 及其 7 天内的纵向变化与 ICU 住院时间均无相关性。与幸存者相比，7 天内 AT 的 MLT 变化在 ICU 非幸存者中明显更大。
前颞肌超声肌肉层厚度和灰度参数的测量与股四头肌的测量没有很好的相关性。
