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超声评估危重症患者肌肉量与临床结局的相关性:一项前瞻性观察研究。

Ultrasound assessment of muscle mass and correlation with clinical outcomes in critically ill patients: a prospective observational study.

机构信息

Master's in Physiology, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.

Intensive Care Unit, Hospital Universitario Nacional de Colombia, Bogotá, Colombia.

出版信息

J Ultrasound. 2023 Dec;26(4):879-889. doi: 10.1007/s40477-023-00823-2. Epub 2023 Oct 2.

Abstract

PURPOSE

Muscular atrophy implies structural and functional alterations related to muscular force production and movement. This condition has been reported to be the main reason for generalized muscle weakness; it reflects the severity of the disease and can have a profound impact on short- and long-term clinical outcomes. The purpose of this study was to determine whether muscle atrophy ultrasound parameters early predict muscle weakness, morbidity, or 28-days mortality.

METHODS

This was a prospective, observational single center cohort study. Ultrasound was used to determine the cross-sectional area and muscle thickness of the rectus femoris on the first and third day of ICU stay. The main outcome was the incidence of significant muscle atrophy (≥ 10%).

RESULTS

Ultrasound measurements were made in 31 patients, 58% (18/31) of which showed significant muscle atrophy. The relative loss of muscle mass per day was 1.78 at 5% per day. The presence of muscle atrophy presents increased risk for limb muscle weakness and handgrip weakness. The 28-days mortality rate was similar in both subgroups.

CONCLUSION

The presence of muscle atrophy presents an increased clinical risk for the development of limb ICUAW and handgrip, although these observations were not statistically significant. The results could be used to plan future studies on this topic.

摘要

目的

肌肉萎缩意味着与肌肉力量产生和运动相关的结构和功能改变。这种情况被报道为全身肌肉无力的主要原因;它反映了疾病的严重程度,并可能对短期和长期的临床结果产生深远影响。本研究的目的是确定肌肉萎缩超声参数是否能早期预测肌肉无力、发病率或 28 天死亡率。

方法

这是一项前瞻性、观察性的单中心队列研究。在 ICU 入住的第 1 天和第 3 天,使用超声确定股直肌的横截面积和肌肉厚度。主要结局是发生显著肌肉萎缩(≥10%)。

结果

对 31 名患者进行了超声测量,其中 58%(18/31)的患者出现了显著的肌肉萎缩。肌肉质量的相对日损失为 1.78%,每天损失 5%。肌肉萎缩的存在增加了四肢 ICUAW 和握力减弱的临床风险。两个亚组的 28 天死亡率相似。

结论

肌肉萎缩的存在增加了发展四肢 ICUAW 和握力的临床风险,尽管这些观察结果没有统计学意义。这些结果可用于计划该主题的未来研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6edc/10632208/04460993cfc6/40477_2023_823_Fig1_HTML.jpg

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