“Evaluation of Peripheral Muscle Thickness Using Ultrasound in Mechanically Ventilated Critically Ill Patients at Trauma Hospital”.

Matias Loch, Javiera Leal, Fabiola Barra, Hans Baez, Sergio Arias
Purpose:

This study aims to quantify the variations in peripheral muscle thickness during the first 7 days in patients with IMV admitted to the Trauma ICU Hospital.

Methods:

Patients over 18 years old, admitted for more than 48 hours, and connected to IMV were included. Diagnosis at admission included polytrauma, severe burns, traumatic brain injury (TBI), acute respiratory failure (ARF), and sepsis. Patients with previous functional or motor limitations were excluded. US evaluation was performed on peripheral muscles of the lower extremities: tibialis anterior (TA), vastus intermedius (VI), rectus femoris (RF), and the quadriceps muscle (QCS). Muscle thickness and echogenicity were recorded at baseline (day 1) and day 7 of ICU stay. Demographic and clinical variables were collected from digital records.

Results:

A total of 36 patients were initially included in the study, with 20 meeting the final inclusion criteria. The patients had a mean age of 43+14 years, most were men (75%). The most frequent admission diagnoses were TBI (50%), thoracic trauma (35%), pelvic trauma (30%), and abdominal trauma (15%). The mean of IMV days was 11+5.2, with 55+56.7 days of ICU stay. All patients received physiotherapy during their first week of hospitalization. The VI muscle exhibited the largest decrease in muscle thickness (38%) by day 7, while the TA muscle showed a modest 10% reduction. No significant changes in muscle quality (echogenicity) were observed after one week of hospitalization.

Conclusion(s):

The study highlights a significant muscle thickness loss, particularly in the quadriceps group, within the first week of ICU admission. The minimal changes in muscle quality suggest that early interventions focusing on muscle preservation are crucial. Ultrasound is an effective, non-invasive tool for monitoring muscle degradation in ICU patients.

Implications:

The results support the importance use of ultrasound in routine ICU assessments, promoting early rehabilitation strategies. Further research is needed to explore long-term muscle recovery post-ICU discharge and the impact of early rehabilitation interventions.

Funding acknowledgements:
This study did not receive any funding.
Keywords:
ICU-acquired weakness
Ultrasound
Peripheral muscles
Primary topic:
Critical care
Second topic:
Musculoskeletal
Third topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Comité ético científico Hospital del Trabajador
Provide the ethics approval number:
CEC/07/2023
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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