Comparison of Two Techniques to Assess Muscle Mass Loss During ICU Stay: Muscle Ultrasound vs Bioelectrical Impedance Analysis.

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  • Additional Information
    • Source:
      Publisher: Elsevier Science Country of Publication: United States NLM ID: 8802712 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1244 (Electronic) Linking ISSN: 08999007 NLM ISO Abbreviation: Nutrition Subsets: MEDLINE
    • Publication Information:
      Publication: Tarrytown, NY : Elsevier Science
      Original Publication: [Burbank, Calif. : Nutrition, c1987-
    • Subject Terms:
      Electric Impedance* ; Intensive Care Units* ; Ultrasonography*/methods ; Ultrasonography*/statistics & numerical data ; Critical Illness* ; Muscle, Skeletal*/diagnostic imaging ; Muscle, Skeletal*/physiopathology ; Length of Stay*/statistics & numerical data; Humans ; Male ; Female ; Middle Aged ; Prospective Studies ; Aged ; Adult ; Muscular Atrophy/diagnostic imaging ; Muscular Atrophy/etiology ; APACHE
    • Abstract:
      Background and Aims: Muscle wasting is a prevalent issue among long-term critically ill patients and is associated with adverse clinical outcomes. Evaluating muscle mass in the ICU presents challenges due to the lack of a consistent methodology and the significant impact of fluid balance range in ICU patients. This prospective study aimed to compare the utility of bioelectrical impedance analysis (BIA) and ultrasound (US) for monitoring muscle wasting in critically ill patients over an initial seven-day period of critical illness.
      Methods: Conducted in a tertiary teaching hospital's mixed ICU, the study included adult patients with ICU stays exceeding seven days. Measurements were taken on Day 1 (within 24 hours of ICU admission), Day 5, and Day 7.
      Results: Out of 101 enrolled patients, 74 were male, with a mean age of 55.3 (SD 14.8) years. The mean APACHE II score was 18.2 (SD 7.2), and the Day 1 SOFA score was 7.9 (SD 3.2). The ICU survival rate was 65%, and the mean ICU length of stay was 19.2 (SD 19.2) days. Statistically significant muscle mass loss was detected by US measurement, demonstrating the relative change in general muscle thickness: -2.5% (SD 11.8) by Day 5 and -6.5% (SD 12.4) by Day 7 (P < 0.001). BIA demonstrated no significant change in phase angle, as the relative change by Day 5 was -3.3% (SD 19.9) and by Day 7 it was -1.9% (SD 21.9), with no significant difference (P = 0.374).
      Conclusions: Ultrasound was a more suitable method for assessing and monitoring muscle wasting during ICU stays, while bioelectrical impedance analysis failed to demonstrate a comparable degree of muscle loss at Days 5 and 7. This study highlights the importance of selecting an appropriate assessment method based on the specific clinical context, emphasizing the reliability of US in evaluating muscle wasting among critically ill patients.
      Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
      (Copyright © 2024. Published by Elsevier Inc.)
    • Contributed Indexing:
      Keywords: Critical care; Muscle ultrasound; Muscle wasting; Phase angle
    • Publication Date:
      Date Created: 20241116 Date Completed: 20241212 Latest Revision: 20241212
    • Publication Date:
      20241213
    • Accession Number:
      10.1016/j.nut.2024.112607
    • Accession Number:
      39549651