Association between muscle wasting and muscle strength in patients who developed severe sepsis and septic shock

Borges, Rodrigo Cerqueira; Soriano, Francisco; Carvalho, Celso

doi:10.1183/13993003.congress-2018.pa4124

Cited by 4 publications

(11 citation statements)

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“…All but seven 8,[14][15][16][17][18][19] authors reported serial US measurements. Of these, only six explicitly reported being conducted after ICU discharge 5,[20][21][22][23][24] (Table 3). The large majority of studies were observational with only six having a randomised study design.…”

Section: Patient Population and Study Designmentioning

confidence: 99%

“…33 The term 'limb extension' was reported by 21 studies. 5,8,[12][13][14][15][16]19,[23][24][25][26][33][34][35][36][37][38][39][40][41] One paper referenced 'legs flat' and was not included as referencing extension. 20 Relaxation of limbs was reported by 11 authors, 5,13,14,16,20,26,35,36,38,39,41 with one using a pillow under the knees for muscular relaxation.…”

Section: Patient Population and Study Designmentioning

confidence: 99%

“…For those studies that included more than one operator (n ¼ 28), three articles clearly stated that the operator was not blinded 16,22,45 and eight that operators were blinded. 8,12,15,25,26,35,36,42 The majority of studies only included one operator (19/37; 51%) with six having two, 8,17,24,25,36,42 one having three 32 and the remaining not reporting this parameter. 14,15,18,20,22,[27][28][29][30]40 Experienced 15,21,23,33,39 or trained 5,8,12,13,16,22,30,32,34,[36][37][38]41,42 operators were referenced in 19 papers.…”

Section: Taking Measuresmentioning

confidence: 99%

“…Four studies acquired measures in duplicate. 13,14,34,36 Triplicate measures were recorded by 13 authors 8,12,17,20,[22][23][24]28,33,37,40,41,45 while three took measures in triplicate only if there was a difference of >10% 5,39 or 0.1 cm. 19 The remaining authors reported taking one, 26 six, 32 or 'the best three images'.…”

Section: Image Analysismentioning

confidence: 99%

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Ultrasonography to measure quadriceps muscle in critically ill patients: A literature review of reported methodologies

Weinel

Summers

Chapple

2019

Anaesth Intensive Care

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Muscle wasting in the intensive care unit (ICU) is common and may impair functional recovery. Ultrasonography (US) presents a modern solution to quantify skeletal muscle size and monitor muscle wasting. However, no standardised methodology for the conduct of ultrasound-derived quadriceps muscle layer thickness or cross-sectional area in this population exists. The aim of this study was to compare methodologies reported for the measurement of quadriceps muscle layer thickness (MLT) and cross-sectional area (CSA) using US in critically ill patients. Databases PubMed, Ovid, Embase, and CINAHL were searched for original research publications that reported US-derived quadriceps MLT and/or CSA conducted in critically ill adult patients. Data were extracted from eligible studies on parameters relating to US measurement including anatomical location, patient positioning, operator technique and image analysis. It was identified that there was a clear lack of reported detail and substantial differences in the reported methodology used for all parameters. A standardised protocol and minimum reporting standards for US-derived measurement of quadriceps muscle size in ICU is required to allow for consistent measurement techniques and hence interpretation of results.

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Section: Patient Population and Study Designmentioning

confidence: 99%

Section: Patient Population and Study Designmentioning

confidence: 99%

Section: Taking Measuresmentioning

confidence: 99%

Section: Image Analysismentioning

confidence: 99%

See 2 more Smart Citations

Ultrasonography to measure quadriceps muscle in critically ill patients: A literature review of reported methodologies

Weinel

Summers

Chapple

2019

Anaesth Intensive Care

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“…At the same time, the bedside ultrasound examination revealed that the cross-sectional area of the patient's left rectus femoris muscle was significantly reduced. ese results demonstrated that there was significant acute skeletal muscle wasting in ICU-AW patients [16]. Muscle protein metabolism disorder has been shown to play an important role in the pathogenesis of ICU-AW [17].…”

Section: Discussionmentioning

confidence: 84%

Utility of Plasma GDF‐15 for Diagnosis and Prognosis Assessment of ICU‐Acquired Weakness in Mechanically Ventilated Patients: Prospective Observational Study

Xie

Liu

Zheng

et al. 2020

BioMed Research International

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Objective. To identify the clinical correlations between plasma growth differentiation factor-15 (GDF-15), skeletal muscle function, and acute muscle wasting in ICU patients with mechanical ventilation. In addition, to investigate its diagnostic value for ICU-acquired weakness (ICU-AW) and its predictive value for 90-day survival in mechanically ventilated patients. Methods. 95 patients with acute respiratory failure, who required mechanical ventilation therapy, were randomly selected among hospitalized patients from June 2017 to January 2019. The plasma GDF-15 level was detected by ELISA, the rectus femoris cross-sectional area (RFcsa) was measured by ultrasound, and the patient’s muscle strength was assessed using the British Medical Research Council (MRC) muscle strength score on day 1, day 4, and day 7. Patients were divided into an ICU-AW group and a non-ICU-AW group according to their MRC-score on the 7th day. The differences in plasma GDF-15 level, MRC-score, and RFcsa between the two groups were compared on the 1st, 4th, and 7th day after being admitted to the ICU. Then, the correlations between plasma GDF-15 level, RFcsa loss, and MRC-score on day 7 were investigated. The receiver operating characteristic curve (ROC) was used to analyze the plasma GDF-15 level, RFcsa loss, and % decrease in RFcsa on the 7th day to the diagnosis of ICU-AW in mechanically ventilated patients. Moreover, the predictive value of GDF-15 on the 90-day survival status of patients was assessed using patient survival curves. Results. Based on whether the 7th day MRC-score was <48, 50 cases were included in the ICU-AW group and 45 cases in the non-ICU-AW group. The length of mechanical ventilation, ICU length of stay, and hospital length of stay were significantly longer in the ICU-AW group than in the non-ICU-AW group (all P<0.05), while the other baseline indicators were not statistically significant between the two groups. As the treatment time increased, the plasma GDF-15 level was significantly increased, the ICU-AW group demonstrated a significant decreasing trend in the MRC-score and RFcsa, while no significant changes were found in the non-ICU-AW group. In the ICU-AW group, the plasma GDF-15 level was significantly higher than that in the non-ICU-AW group, while the RFcsa and the MRC-score were significantly lower than those in the non-ICU-AW group (GDF-15 (pg/ml): 2542.44 ± 629.38 vs. 1542.86 ± 502.86; RFcsa (cm2): 2.04 ± 0.64 vs. 2.34 ± 0.61; MRC-score: 41.22 ± 3.42 vs. 51.42 ± 2.72, all P<0.001). The plasma GDF-15 level was significantly negatively correlated with the MRC-score (r = −0.60), while it was significantly positively correlated with the RFcsa loss (r = 0.18) and the % decrease in RFcsa (r = 0.16). Moreover, the RFcsa loss was significantly negatively correlated with the MRC-score (r = −0.27) (all P<0.001). The ROC curve analysis showed that plasma GDF-15 level, RFcsa loss, and % decrease in RFcsa on day 7 had predictive value for ICU-AW diagnosis in mechanically ventilated patients. More specifically, the area under the ROC curve (AUC) of GDF-15 was 0.904, the AUC of RFcsa loss was 0.873, and the AUC of % decrease in RFcsa was 0.886 (all P<0.001). The 90-day survival curve demonstrated that the survival rate of the high plasma GDF-15 level group was 54.00%, while that of the low plasma GDF-15 level group was 75.56%. The difference between the two groups was statistically significant (P<0.05). Conclusion. The plasma GDF-15 concentration level was significantly associated with skeletal muscle function and muscle wasting on day 7 in ICU patients with mechanical ventilation. Therefore, it can be concluded that the plasma GDF-15 level on the 7th day has a high diagnostic yield for ICU-acquired muscle weakness, and it can predict the 90-day survival status of ICU mechanically ventilated patients.

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The time course of disuse muscle atrophy of the lower limb in health and disease

Hardy

Inns

Hatt

et al. 2022

J cachexia sarcopenia muscle

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Short, intermittent episodes of disuse muscle atrophy (DMA) may have negative impact on age related muscle loss. There is evidence of variability in rate of DMA between muscles and over the duration of immobilization. As yet, this is poorly characterized. This review aims to establish and compare the time‐course of DMA in immobilized human lower limb muscles in both healthy and critically ill individuals, exploring evidence for an acute phase of DMA and differential rates of atrophy between and muscle groups. MEDLINE, Embase, CINHAL and CENTRAL databases were searched from inception to April 2021 for any study of human lower limb immobilization reporting muscle volume, cross‐sectional area (CSA), architecture or lean leg mass over multiple post‐immobilization timepoints. Risk of bias was assessed using ROBINS‐I. Where possible meta‐analysis was performed using a DerSimonian and Laird random effects model with effect sizes reported as mean differences (MD) with 95% confidence intervals (95% CI) at various time‐points and a narrative review when meta‐analysis was not possible. Twenty‐nine studies were included, 12 in healthy volunteers (total n = 140), 18 in patients on an Intensive Therapy Unit (ITU) (total n = 516) and 3 in patients with ankle fracture (total n = 39). The majority of included studies are at moderate risk of bias. Rate of quadriceps atrophy over the first 14 days was significantly greater in the ITU patients (MD −1.01 95% CI −1.32, −0.69), than healthy cohorts (MD −0.12 95% CI −0.49, 0.24) (P < 0.001). Rates of atrophy appeared to vary between muscle groups (greatest in triceps surae (−11.2% day 28), followed by quadriceps (−9.2% day 28), then hamstrings (−6.5% day 28), then foot dorsiflexors (−3.2% day 28)). Rates of atrophy appear to decrease over time in healthy quadriceps (−6.5% day 14 vs. −9.1% day 28) and triceps surae (−7.8% day 14 vs. −11.2% day 28), and ITU quadriceps (−13.2% day 7 vs. −28.2% day 14). There appears to be variability in the rate of DMA between muscle groups, and more rapid atrophy during the earliest period of immobilization, indicating different mechanisms being dominant at different timepoints. Rates of atrophy are greater amongst critically unwell patients. Overall evidence is limited, and existing data has wide variability in the measures reported. Further work is required to fully characterize the time course of DMA in both health and disease.

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Association between muscle wasting and muscle strength in patients who developed severe sepsis and septic shock

Cited by 4 publications

References 0 publications

Ultrasonography to measure quadriceps muscle in critically ill patients: A literature review of reported methodologies

Ultrasonography to measure quadriceps muscle in critically ill patients: A literature review of reported methodologies

Utility of Plasma GDF‐15 for Diagnosis and Prognosis Assessment of ICU‐Acquired Weakness in Mechanically Ventilated Patients: Prospective Observational Study

The time course of disuse muscle atrophy of the lower limb in health and disease

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