Naik Shweta S, Desai Meshwa, Krishnakumar Mathangi, Nashi Saraswati, Varadarajan Bhadrinarayan
Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Department of Surgical and Neuro ICU, Department of Anaesthesia, St John's Medical College and Hospital, Bengaluru, Karnataka, India.
Indian J Crit Care Med. 2025 Mar;29(3):262-267. doi: 10.5005/jp-journals-10071-24928. Epub 2025 Feb 28.
Guillain-Barré syndrome (GBS) is associated with significant muscle loss, which can result in prolonged intensive care. The aim of this study was to evaluate muscle atrophy in GBS patients using serial ultrasound measurements of rectus femoris cross-sectional area (RFCSA).
A prospective study was carried out among GBS patients admitted to the intensive care unit (ICU). All clinical and demographic variables were recorded at admission.Ultrasound measurement of RFCSA was done at baseline and 3, 7, and 14 days after ICU admission. Clinical outcomes such as the ICU stay and duration of mechanical ventilation were studied at discharge.
A total of 25 patients were studied. The mean age was 48.96 ± 14.82 years, 44% were female, and 25% experienced significant muscle atrophy in the first 72 hours. The percentage changes in the RFCSA were 5.21 (3.38-8.39), 9.18 (5.52-11.76), and 12.63 (8.65-15.09) on days 3, 7, and 14, respectively. A greater muscle atrophy rate was strongly positively correlated with longer ventilation periods [atrophy day 14 ( = 0.88, < 0.001)] and atrophy day 7 ( = 0.87, < 0.001) and total number of ICU days [atrophy day 14 ( = 0.93, < 0.001)].
Muscle ultrasound (MUSG) shows potential as a tool for monitoring muscle atrophy in GBS patients. However, its ability to reliably identify patients at risk for prolonged ICU stays and mechanical ventilation requires cautious interpretation and further validation due to the absence of a comparator.
The findings of this study highlight the utility of bedside MUSG as a non-invasive tool for monitoring muscle atrophy in neuromuscular diseases and critically ill patients.Early identification of significant muscle loss allows for timely interventions, risk stratification, and resource optimization, ultimately improving ICU outcomes and patient recovery trajectories.
Naik SS, Desai M, Krishnakumar M, Nashi S, Varadarajan B. The Utility of Muscle Ultrasound as a Predictor of Outcome in Guillain-Barré Syndrome Patients in the Intensive Care Unit: A Prospective Cohort Study. Indian J Crit Care Med 2025;29(3):262-267.
吉兰 - 巴雷综合征（GBS）与显著的肌肉流失有关，这可能导致延长重症监护时间。本研究的目的是通过对股直肌横截面积（RFCSA）进行系列超声测量来评估GBS患者的肌肉萎缩情况。
对入住重症监护病房（ICU）的GBS患者进行了一项前瞻性研究。入院时记录所有临床和人口统计学变量。在基线以及ICU入院后3天、7天和14天对RFCSA进行超声测量。出院时研究诸如ICU住院时间和机械通气时间等临床结局。
共研究了25例患者。平均年龄为48.96±14.82岁，44%为女性，25%在最初72小时内出现显著肌肉萎缩。RFCSA在第3天、第7天和第14天的百分比变化分别为5.21（3.38 - 8.39）、9.18（5.52 - 11.76）和12.63（8.65 - 15.09）。更大的肌肉萎缩率与更长的通气时间[第14天萎缩（r = 0.88，P < 0.001）]、第7天萎缩（r = 0.87，P < 0.001）以及ICU总天数[第14天萎缩（r = 0.93，P < 0.001）]呈强正相关。
肌肉超声（MUSG）显示出作为监测GBS患者肌肉萎缩工具的潜力。然而，由于缺乏对照，其可靠识别有延长ICU住院时间和机械通气风险患者的能力需要谨慎解读并进一步验证。
本研究结果突出了床边MUSG作为监测神经肌肉疾病和重症患者肌肉萎缩的非侵入性工具的实用性。早期识别显著的肌肉流失有助于及时干预、风险分层和资源优化，最终改善ICU结局和患者康复轨迹。
Naik SS, Desai M, Krishnakumar M, Nashi S, Varadarajan B. The Utility of Muscle Ultrasound as a Predictor of Outcome in Guillain-Barré Syndrome Patients in the Intensive Care Unit: A Prospective Cohort Study. Indian J Crit Care Med 2025;29(3):262 - 267.
