OR09: Analysis of the Body Composition on 3rd Lumbar Vertebra (L3)-Targeted Computed Tomography (CT)-Scan in the Intensive Care Unit (ICU): Prognostic Value, Interobserver Reproducibility, and Prevalence of Muscle Mass Impairment

Aim. Sarcopenia, a core component of physical frailty, is an independent risk factor for suboptimal health outcomes in hospitalized patients, especially in the intensive care patients. Psoas muscle areas can be assessed to identify sarcopenia. The aim of this study was to determine the prognostic value of psoas muscle area measured with CT for the prediction of in-hospital mortality in patients with pulmonary embolism at admission to the intensive care unit. Methods. Patients with an admission abdominal computed tomography scan and requiring intensive care unit (ICU) stay were reviewed. Selected clinical data of patients admitted to intensive care unit for the management of pulmonary embolism were collected. Using CT scan images at the level of L3 vertebra, the psoas muscle area value was obtained by dividing the sum of the right and left psoas muscle areas into the body surface area. Results. In-hospital mortality rate was 22.5% in 89 patients. The pulmonary embolism patients with in-hospital mortality had higher PESI and lower value of psoas muscle area, in addition to the lower systolic blood pressure and arterial oxygen saturation at admission. The increase in the value of psoas muscle area is associated with a decrease in the rate of in-hospital mortality. In patients with in-hospital mortality related to pulmonary embolism, the higher PESI and the lower value of psoas muscle area were considered in accordance with the outcome of patients. Conclusions. For the prediction of in-hospital mortality risk in patients with pulmonary embolism managed in intensive care unit, the psoas muscle area value has a merit to be used among the routine diagnostic procedures after further studies conducted with different severity of pulmonary embolism.

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OP039 MUSCULAR MASS ASSESSMENT USING THIRD LUMBAR VERTEBRA (L3)-TARGETED COMPUTED TOMOGRAPHY (CT) IN THE INTENSIVE CARE UNIT (ICU): A FEASIBILITY STUDY

Clinical Nutrition ◽

10.1016/s0261-5614(13)60041-2 ◽

2013 ◽

Vol 32 ◽

pp. S16-S17

Author(s):

R. Thibault ◽

A. Ait Hssain ◽

S. Dadet ◽

B. Pereira ◽

S. Antoun ◽

...

Keyword(s):

Computed Tomography ◽

Intensive Care Unit ◽

Intensive Care ◽

Feasibility Study ◽

Lumbar Vertebra

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Quantification of Adipose Tissue and Muscle Mass Based on Computed Tomography Scans: Comparison of Eight Planimetric and Diametric Techniques Including a Step-By-Step Guide

European Surgical Research ◽

10.1159/000486173 ◽

2018 ◽

Vol 59 (1-2) ◽

pp. 23-34 ◽

Cited By ~ 4

Author(s):

Thomas Irlbeck ◽

Silke Janitza ◽

Balázs Poros ◽

Monika Golebiewski ◽

Lorenz Frey ◽

...

Keyword(s):

Computed Tomography ◽

Body Composition ◽

Adipose Tissue ◽

Muscle Mass ◽

Interobserver Reliability ◽

Pearson Correlation ◽

The Body ◽

Cross Sectional ◽

Single Cross ◽

Planimetric Measurements

Background: Recent scientific work proved that knowledge about body composition beyond the body mass index is essential. Both adipose tissue and muscular status are determining risk factors of morbidity and mortality. Analysis of single cross-sectional computed tomography (CT) images, acquired during routine care only to prevent additional radiation exposure, provide a detailed insight into the body composition of chronically and critically ill patients. Methods: This retrospective study included 490 trauma patients of whom a whole-body multiple detector CT scan was acquired at admission. From a single cross-sectional CT, we compared eight diametric and planimetric techniques for the assessment of core muscle mass as well as visceral and subcutaneous adipose tissue. Furthermore, we derived formulas for converting the measurement results of various techniques into each other. Results: For intra- and interobserver reliability, we obtained intraclass correlation coefficients (ICCs) ranging from 0.947 to 0.997 (intraobserver reliability) and from 0.850 to 0.998 (interobserver reliability) for planimetric measurements. Diametric techniques conferred lower ICCs with 0.851–0.995 and 0.833–0.971, respectively. Overall, area-based measurements of abdominal adipose tissue yielded highly correlated results with diametric measures of obesity. For example, the Pearson correlation of visceral adipose tissue and sagittal abdominal diameter was 0.87 for male and 0.82 for female patients. Planimetric and diametric muscle measurements correlated best for lean psoas area and bilateral diametric measurement of the psoas with a Pearson correlation of 0.90 and 0.93 for male and female patients, respectively. Conclusion: Planimetric measurements should remain the gold standard to describe fat and muscle compartments. Diametric measurements could however serve as a surrogate if planimetric techniques are not readily available or feasible as for example in large registries.

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Analysis of Association between CT-assessed Body Composition and Survival Composition of Patients with Sepsis in EICU

10.21203/rs.3.rs-156786/v1 ◽

2021 ◽

Author(s):

Tian Yun Xu ◽

He Zhang ◽

Jie Zhi Li ◽

Nan Wang

Keyword(s):

Skeletal Muscle ◽

Intensive Care Unit ◽

Body Composition ◽

Intensive Care ◽

Mortality Rate ◽

Ct Scan ◽

Cox Regression ◽

Apache Ii ◽

Apache Ii Score ◽

Survival Group

Abstract Background: The prevalence of sepsis among patients in the intensive care unit is high. Thus, the evaluation of prognosis in these patients is paramount. This study aimed to appraise the role of the abdominal composition quantified from computed tomography (CT) scan in predicting a 90-day mortality rate among patients with sepsis in the emergency intensive care unit (EICU).Method: Through Cox regression analysis, the skeletal muscle density (SMD, skeletal muscle area (SMA), and subcutaneous adipose tissue area (SAT) assessed by the CT abdomen were associated with the 90-day mortality rate, with adjustment to the acute physiology and chronic health assessment (APACHE II) score, sequential organ failure assessment (SOFA) score, and BMI. Linear regression was performed to analyze other clinical factors.Result: The Cox regression analyses showed that compared with the non-survival group at 90-day, patients with a higher SMD (HR per 10 HU = 0.619; 95% CI = 0.450 - 0.853; p = 0.003), SMA (HR per 10 cm2 = 0.870; 95% CI = 0.781 - 0.969; p = 0.011), and SAT (HR per 10 cm2 = 0.954; 95% CI = 0.912 - 0.999; P = 0.047) were significantly associated with a lower 90-day mortality rate. These significant correlations persisted after adjusting for the BMI, APACHE II, and SOFA scores. Further analysis revealed gender differences in the SMD and skeletal muscle index (SMI) between the survival and the non-survival group.Conclusion: The content of body composition assessed by an abdominal CT scan is highly associated with the 90-day mortality of patients with sepsis in the EICU, of which the SMD, SMA, and SAT represent valuable prognostic factors.

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Computed Tomography of the Chest in the Intensive Care Unit

Critical Care Clinics ◽

10.1016/s0749-0704(18)30128-3 ◽

1994 ◽

Vol 10 (2) ◽

pp. 267-275 ◽

Cited By ~ 11

Author(s):

Barry H. Gross ◽

David L. Spizarny

Keyword(s):

Computed Tomography ◽

Intensive Care Unit ◽

Intensive Care

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Clinical implication of psoas muscle mass measurement for predicting death within 3 months in patients with incurable uterine cervical or corpus malignancy

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa248 ◽

2021 ◽

Author(s):

Hiroyuki Kurosu ◽

Yukiharu Todo ◽

Ryutaro Yamada ◽

Kaoru Minowa ◽

Tomohiko Tsuruta ◽

...

Keyword(s):

Computed Tomography ◽

Muscle Mass ◽

Cancer Cachexia ◽

Mass Measurement ◽

Characteristic Curve ◽

Lumbar Vertebra ◽

Psoas Muscle ◽

Data Set ◽

Cutoff Value ◽

Computed Tomography Images

Abstract Objective The aim of this study was to find a clinical marker for identifying refractory cancer cachexia. Methods We analyzed computed tomography imaging data, which included the third lumbar vertebra, from 94 patients who died of uterine cervix or corpus malignancy. The time between the date of examination and date of death was the most important attribute for this study, and the computed tomography images were classified into >3 months before death and ≤ 3 months before death. Psoas muscle mass index was defined as the left–right sum of the psoas muscle areas (cm2) at the level of third lumbar vertebra, divided by height squared (m2). Results A data set of 94 computed tomography images was obtained at baseline hospital visit, and a data set of 603 images was obtained at other times. One hundred (16.6%) of the 603 non-baseline images were scanned ≤3 months before death. Mean psoas muscle mass index change rates at >3 months before death and ≤3 months before death were −1.3 and −20.1%, respectively (P < 0.001). Receiver operating characteristic curve analysis yielded a cutoff value of −13.0%. The area under the curve reached a moderate accuracy level (0.777, 95% confidence interval 0.715–0.838). When we used the cutoff value to predict death within 3 months, sensitivity and specificity were 74.0 and 82.1%, respectively. Conclusions Measuring change in psoas muscle mass index might be useful for predicting cancer mortality within 3 months. It could become a potential tool for identifying refractory cancer cachexia.

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Long-term Outcome in Chest Trauma

Anesthesiology ◽

10.1097/aln.0b013e31818a4009 ◽

2008 ◽

Vol 109 (5) ◽

pp. 864-871 ◽

Cited By ~ 26

Author(s):

Marc Leone ◽

Fabienne Brégeon ◽

François Antonini ◽

Kathia Chaumoître ◽

Aude Charvet ◽

...

Keyword(s):

Computed Tomography ◽

Intensive Care Unit ◽

Intensive Care ◽

Chest Trauma ◽

Computed Tomography Scan ◽

Walk Distance ◽

Chest Computed Tomography ◽

Tomography Scan

Background Currently, there are limited data available describing the long-term outcomes of chest trauma survivors. Here, the authors sought to describe chest trauma survivor outcomes 6 months and 1 yr after discharge from the intensive care unit, paying special attention to pulmonary outcomes. Methods A cohort of 105 multiple trauma patients with blunt chest trauma admitted to the intensive care unit was longitudinally evaluated. After 6 months, a chest computed tomography scan, pulmonary function testing (PFT), and quality of life were collected in 55 of these patients. A subgroup of 38 patients was followed up for 1 yr. Results At least one abnormal PFT result was found in 39 patients (71%). Compared with normalized data of the age- and sex-matched population, physical function was decreased in 38 patients (70%). The 6-min walk distance was reduced for 29 patients (72%). Although pathologic images were observed on the chest computed tomography scan from 33 patients (60%), no relation was found between PFT and computed tomography. A ratio of arterial oxygen pressure to inspired oxygen fraction less than 200 at admission to the intensive care unit predicted an abnormal PFT result at 6 months. One year after discharge from the intensive care unit, paired comparisons showed a significant increase in forced vital capacity (P = 0.02) and Karnofsky Performance Status (P < 0.001). Conclusions Survivors of multiple traumas including chest trauma demonstrate a persistent decrease in the 6-min walk distance, impairment on PFT, and reduced pulmonary-specific quality of life.

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CASE STUDY: ORGANOPHOSPHATE POISONING – ATROPINE-INDUCED PSYCHOSIS IN INTENSIVE CARE UNIT PATIENT

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i1.39921 ◽

2021 ◽

pp. 3-4

Author(s):

VATHSALYA PORANKI

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Intensive Care Unit Patient ◽

Rural Areas ◽

Postsynaptic Membrane ◽

The Body ◽

Organophosphate Poisoning ◽

Competitive Antagonist ◽

Organophosphorus Poisoning

Organophosphate compounds are used as commercial insecticides and applied as aerosols or dust. Consuming these compounds intentionally or unintentionally lead to dangerous conditions even to fatality. The most common obstacle in treating organophosphorus poisoning is the availability of sufficient medical care, equipment to provide proper emergency care observed in rural areas where there is a lot of gap between intensive care and acute care. Atropine use is as an antidote in organophosphorus poisoning. The dose of atropine mainly depends on the organophosphorus toxic doses. Atropine is a competitive antagonist of acetylcholine at the muscarinic postsynaptic membrane. Atropine blocks all the muscarinic effects in the body. This study presents a case of organophosphorus poisoning treated with atropine leading to atropine psychosis. Patient’s conditions, outcomes, and improvements are studied.

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