scholarly journals Evaluation of Sarcopenia by Ultrasound of the Rectus Femoris Muscle as a Predictor of Outcomes of Surgical Intensive Care Unit Patients, A Prospective, Observational Study

2021 ◽  
pp. 43-52
Author(s):  
Aya Hassan Hegazy ◽  
Mohammad Samir Abd El-Ghafar ◽  
Nagat Sayed El-shmaa ◽  
Sohair Moustafa Soliman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Surgical Intensive Care Unit ◽  
Sectional Area ◽  
Surgical Intensive Care ◽  
Cross Sectional ◽  
Rectus Femoris Muscle ◽  
Femoris Muscle

Background: Muscle wasting is a frequent finding in critically ill patients and is associated with worse short- and long term outcomes. Loss of mass and function of skeletal muscles starts early - in the first 24 hours after admission to Intensive Care Unit (ICU) - and may persist for years ‘Post-ICU syndrome’. Ultrasound of rectus femoris muscle is a valid and simple technique that could be used for longitudinal assessment of treatment success and facilitates the use of postoperative interventions that help in problems related to critical illness. The aim of this study is to evaluate sarcopenia by ultrasound of rectus femoris muscle as a predictor of outcomes of surgical intensive care unit. Materials and Methods: This prospective observational study was performed on 40 patients admitted to the surgical ICU, Tanta University Hospitals, Egypt, after approval of the Institutional Ethical Committee, Tanta University. The study started from April 2019 till January 2020. An informed consent was taken from the nearest relatives of the patients. All data of the patients was confidential with secret codes and private files for each patient. All given data was used for the current medical research only. Any unexpected risks appeared during the course of the research were cleared to the participants and ethical committee at time. Results: Cross-sectional area of rectus femoris muscle decreased significantly at all-time measurements as compared to the baseline at day 0 (within 24 hours from SICU admission), 5, 10, 15, 20, 25 and 30. There were negative correlations between delta cross-sectional area of rectus femoris muscle and age, height, weight, Body Mass Index and baseline cross-sectional area of rectus femoris muscle. There was a positive correlation between delta cross-sectional area of rectus femoris muscle and duration of mechanical ventilation, ICU length of stay and mortality. Conclusion: Rectus femoris cross-sectional area measured by B-mode ultrasonography showed significant role in nutritional assessment as it decreases in critically ill patients with positive correlation with duration of mechanical ventilation and ICU stay.

scholarly journals Reliability and differences in quadriceps femoris muscle morphology using ultrasonography: The effects of body position and rest time

Ultrasound ◽  
2018 ◽  
Vol 26 (4) ◽  
pp. 214-221 ◽  
Author(s):  
Patrick M Tomko ◽  
Tyler WD Muddle ◽  
Mitchel A Magrini ◽  
Ryan J Colquhoun ◽  
Micheal J Luera ◽  
...  
Keyword(s):  
Supine Position ◽  
Rest Period ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Echo Intensity ◽  
Cross Sectional ◽  
Muscle Cross Sectional Area ◽  
Rectus Femoris Muscle ◽  
Femoris Muscle

Introduction The purpose of this investigation was to: (1) to determine the reliability of rectus femoris muscle cross-sectional area and echo intensity obtained using panoramic ultrasound imaging during seated and supine lying positions before and after a 5-minute rest period and (2) to determine the influence of body position and rest period on the magnitude of rectus femoris muscle cross-sectional area and echo intensity measurements. Methods A total of 23 males and females (age = 21.5 ± 1.9 years) visited the laboratory on two separate occasions. During each visit, panoramic ultrasound images of the rectus femoris were obtained in both a seated and a supine position before (T1) and after a 5-minute (T2) rest period to quantify any potential changes in either muscle cross-sectional area and/or echo intensity. Results None of the muscle cross-sectional area or echo intensity measurements exhibited systematic variability, and the ICCs were 0.98–0.99 and 0.88–0.91, and the coefficients of variation were ≤ 3.9% and ≤ 8.2% for muscle cross-sectional area and echo intensity, respectively. Our results indicated that muscle cross-sectional area was greater in the seated than supine position, whereas echo intensity was greater in the supine position. Further, echo intensity increased in the seated position from T1 to T2. Conclusion Both rectus femoris muscle cross-sectional area and echo intensity may be reliably measured in either a seated or supine lying position before or after a 5-minute rest period. Aside from echo intensity in the seated position, rest period had no influence on the magnitude of muscle cross-sectional area or echo intensity. Comparison of muscle cross-sectional area values that are obtained in different body positions is ill-advised.

scholarly journals Rectus femoris muscle thickness and cross-sectional area on ultrasonography may predict isometric and isokinetic knee extension strength: A cross-sectional study

2021 ◽  
Author(s):  
Ufuk Şekir 9) ◽  
Uğur Can Yalaki ◽  
Bedrettin Akova
Keyword(s):  
Vastus Lateralis ◽  
Muscle Thickness ◽  
Rectus Femoris ◽  
Pennation Angle ◽  
Cross Sectional Area ◽  
Isokinetic Strength ◽  
Sectional Area ◽  
Cross Sectional ◽  
Rectus Femoris Muscle ◽  
Femoris Muscle

Objective: To examine the relationship between knee extensor strength and quadriceps muscle architecture evaluated with ultrasonography during relaxed and contracted situations. Materials and Methods: A total of 40 healthy participants (age range 18-40), doing sports at a recreational level were included. Pennation angle, muscle thickness, and cross-sectional area of the vastus medialis, vastus lateralis, and rectus femoris muscles were measured firstly during rest while participants are sitting on an isokinetic dynamometer with their knees at 0° and 60° of flexion. Thereafter, ultrasound evaluations were performed during maximal isometric contraction at 60° knee flexion and maximal isokinetic contraction at 30°/sec and 60°/sec speeds. The architectural parameters were correlated with peak isometric (measured at 60° knee flexion) and isokinetic (measured at 30°/sec and 60°/sec angular velocities) torque values. Results: Pennation angle (p<0.001), muscle thickness (p<0.001) and muscle cross-sectional area (p<0.001) of the vastus medialis muscle during rest, and isometric and isokinetic maximal contractions were higher than the vastus lateralis and rectus femoris muscles. Pennation angle, muscle thickness and muscle cross-sectional area parameters measured during rest, and isometric and isokinetic maximal contractions in the vastus medialis (r=0.39-0.64, p<0.05-0.01) and vastus lateralis (r=0.36-0.68, p<0.05-0.01) showed weak to moderate correlations with isometric and isokinetic peak torque. In rectus femoris muscle, on the other hand, except the weak correlation in pennation angle (r=0.35-0.49, p<0.05-0.01), muscle thickness (r=0.74-0.80, p<0.001) and cross-sectional area (r=0.71-0.80, p<0.001) had a moderate to strong correlation with isometric and isokinetic strength. Stepwise regression analysis indicated that rectus femoris cross-sectional area measured during knee relaxed at 60° flexion (R2=0.532-0.610) and rectus femoris muscle thickness measured during isometric and isokinetic contraction modes (R2=0.538-0.600) were decisive to predict the isometric and isokinetic strength of the quadriceps muscle. Conclusion: Contrary to pennation angle, muscle thickness and cross-sectional area of the rectus femoris measured during relaxed and contracted conditions may be determinative in predicting isometric and isokinetic strength.

scholarly journals Changes in Quantitative Muscle Ultrasound for Diagnosis of Intensive Care Unit-Acquired Weakness in Critically Ill Patients

2020 ◽  
Author(s):  
Weiqing Zhang ◽  
Jun Wu ◽  
Qiuying Gu ◽  
Yanting Gu ◽  
Yujin Zhao ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Diagnostic Accuracy ◽  
Rectus Femoris ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Vastus Intermedius ◽  
The Right ◽  
Muscle Ultrasound

Abstract Background: A common occurrence in severe illness is muscle wasting, which is defined as intensive care unit acquired weakness (ICU-AW) and characterized by flaccid tetraparesis with areflexia or hyporeflexia. Many studies revealed the tendency of changes in quantitative muscle ultrasound parameters in critical illnesses; however, the relation between those changes in muscle parameters and intensive care unit acquired weakness was unknown.Objectives: Using the Medical Research Council Criteria, test the accuracy in diagnosis of changes in quantitative muscle ultrasound for diagnosing intensive care unit acquired weakness.Methods: Patients who were conscious and positively responded to verbal commands with facial muscles were subjected to quantitative muscle ultrasonography including measuring thickness and cross-sectional area of biceps brachii (BB) muscle, vastus intermedius (VI) muscle, and rectus femoris (RF) muscles for 4 times in the next 10 days after assessing their muscle strength using the Medical Research Council score. Assessment of the diagnostic accuracy of changes in cross-sectional area and thickness of different muscle groups was made using area under the curve of the receiver operating characteristic curve (ROC–AUC). We also calculated specificity, sensitivity, negative predictive value, positive predictive value, and diagnostic accuracy of 15% threshold for reduction of thickness and 12% threshold for reduction of cross-sectional area.Results: 37 patients underwent muscle ultrasonography for 4 times and 24 were found to have ICW-AW. ROC–AUC of changes in muscle parameters were acceptable and ranged from 0.647 to 0.727. The changes in the thickness of vastus intermedius muscle on both sides while the change in thickness and cross-sectional area of rectus femoris muscle on the right side showed good diagnostic accuracy and ranged from 75.7% to 78.4%.Conclusions: Ultrasonography of the changes in muscle parameters with good diagnostic accuracy is an alternative approach for making a diagnosis of intensive care unit acquired weakness. Particularly, changes in the thickness of vastus intermedius muscle on both sides and changes in thickness and cross-sectional area of rectus femoris muscle on the right side have diagnostic potential.

scholarly journals Nosocomial infections in a pediatric surgical intensive care unit: An unicentric cross-sectional study

2021 ◽  
Vol 74 (3-4) ◽  
pp. 112-116
Author(s):  
Marina Pandurov ◽  
Izabella Fabri-Galambos ◽  
Andjela Opancina ◽  
Anna Uram-Benka ◽  
Goran Rakic ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infections ◽  
Hospital Length Of Stay ◽  
Surgical Intensive Care Unit ◽  
Negative Consequences ◽  
Surgical Intensive Care ◽  
Acinetobacter Baumanii ◽  
Cross Sectional ◽  
The Impact

Introduction. Nosocomial infections are a common complication in patients hospitalized in intensive care units. The aims of this research were to examine the incidence of nosocomial infections in patients admitted to the pediatric surgical intensive care unit, the impact of hospital length of stay and type of surgical disease on the incidence of nosocomial infections, the frequency of microorganisms causing nosocomial infections and their antibiotic susceptibility profile. Material and Methods. Data on 50 subjects were extracted from the database. The following data were taken from the medical histories of the examinees: age, sex, diagnosis, number of days at the hospital before admission to the intensive care unit, number of days in the intensive care unit, levels of C-reactive protein, applied antimicrobial drugs, isolated microorganisms and their susceptibility to antibiotics. Results. The incidence of nosocomial infections in the study period was 52%. Patients who developed nosocomial infection remained longer in the intensive care unit than those who did not develop it (p = 0.003). Patients with the diagnosis of acute abdomen had a statistically significantly higher incidence of nosocomial infections compared to other patients (p = 0.001). Gram-negative bacteria were the most commonly isolated pathogens (46.8%). Acinetobacter baumanii proved to be the most resistant species in this study, since 80% of the strains did not show sensitivity to any of the tested antibiotics. Conclusion. Nosocomial infections are present in slightly more than half of the patients treated at the pediatric surgical intensive care unit. Patients who developed nosocomial infections stayed longer in the pediatric surgical intensive care unit, which had negative consequences for their health and treatment costs.

Sign in / Sign up

Export Citation Format

Share Document