Myopathic characteristics in septic mechanically ventilated patients

Baldwin, Claire; Bersten, Andrew D.

doi:10.1097/mco.0000000000000165

Cited by 7 publications

(4 citation statements)

References 62 publications

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“…With advances in ultrasound imaging, quantitative neuromuscular ultrasound holds the potential to evaluate nerve and muscle early in the course of disease using noninvasive means. Already, it is increasingly employed as a research outcome measure in critically ill populations 4‐7 . Recent reviews suggest that reliability of these measures has not yet been fully established, with few studies demonstrating excellent methodology when evaluated using standards developed by Guidelines for Reporting Reliability and Agreement Studies (GRRAS) and underestimated data acquired via more invasive muscle biopsy 8‐11 .…”

Section: Introductionmentioning

confidence: 99%

Interrater reliability of quantitative ultrasound measures of muscle in critically ill patients

Baston

Gellhorn

Hough

et al. 2022

PM&R

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Background Quantitative neuromuscular ultrasound is increasingly used to study muscle pathology and changes in muscle mass during critical illness. Advantages of ultrasound are high axial resolution, low procedural risks, no ionizing radiation, and ease of use early in the course of disease. However, ultrasound is known to be an operator dependent imaging modality and the intensive care unit setting poses additional challenges to obtaining reliable measurements. There is limited evidence validating the feasibility and reliability of its application in this setting. Objective To conduct a standardized protocol for measuring muscle linear depth and cross‐sectional area in critically ill populations with a high degree of interrater agreement and feasibility. Design Prospective observational cohort study of interrater reliability. Setting Medical intensive care unit at an academic medical center and a level one trauma and burn center. Patients Fifteen critically ill patients were evaluated using a standardized ultrasound protocol measuring total elbow flexor, knee extensor, and tibialis anterior depth, as well as rectus femoris cross‐sectional area. Each site was independently scanned by two investigators. Reliability of measurements between observers was determined by calculating intraclass correlation coefficients (ICCs) using a two‐way random effects model and absolute agreement. An ICC > 0.75 was considered good and >0.90 was considered excellent. Results In critically ill patients, interrater reliability of linear depth measured at elbow flexor, knee extensor, tibialis anterior, and cross‐sectional area of rectus femoris sites was good to excellent with ICC between 0.87 (0.54–0.97) and 0.99 (0.97–1.00). Interrater reliability was improved by creating a summary index of measures resulting in an ICC of 0.99 (0.98–1.00). Feasibility, as definite by the percentage of each measure that was obtainable, ranged from 75%–100%. Conclusions Using a standardized protocol, ultrasound measures obtained in critically ill patients demonstrated high levels of interrater agreement with good to excellent feasibility.

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Section: Introductionmentioning

confidence: 99%

Interrater reliability of quantitative ultrasound measures of muscle in critically ill patients

Baston

Gellhorn

Hough

et al. 2022

PM&R

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“…We believe that the above risk factors leading to children’s gross motor developmental dysfunction may have three pathways: 1. Prolonged mechanical ventilation and sepsis can lead to limb muscle atrophy [43, 44], resulting in weakened muscle strength in children; thus, abnormal assessment results may be due to weakened muscle strength; 2. Studies have confirmed that sepsis and IMV can cause brain dysfunction [45, 46].…”

Section: Discussionmentioning

confidence: 99%

Gross motor developmental dysfunctional outcomes in infantile and toddler pediatric intensive care unit survivors

et al. 2019

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BackgroundIncreasing studies have focused on motor function/dysfunction in PICU survivors; however, most studies have focused on adults and older children. This study investigated gross motor developmental function outcomes in infantile and toddler pediatric intensive care unit (PICU) survivors and the factors associated with gross motor developmental functions.MethodsThis observational study was conducted in the PICU of the First Hospital of Jilin University between January 2019 and March 2019. Thirty-five eligible patients were divided into the dysfunctional (n = 24) or non-dysfunctional (n = 11) group according to the results of the Peabody Developmental Motor Scales, Second Edition (PDMS-2). Baseline gross motor function for all participants before PICU admission was measured via the Age and Stages Questionnaires, Third Edition (ASQ-3). The PDMS-2 was used to evaluate gross motor development function before PICU discharge.ResultsThe gross motor developmental dysfunction incidence was 68.6%. Linear correlation analysis showed that the gross motor quotient (GMQ) was positively correlated with the pediatric critical illness score (PCIS, r = 0.621, P < 0.001), and negatively correlated with length of PICU stay (r = − 0.556, P = 0.001), days sedated (r = − 0.602, P < 0.001), days on invasive mechanical ventilation (IMV; r = − 0.686, P < 0.001), and days on continuous renal replacement therapy (CRRT; r = − 0.538, P = 0.001). Linear regression analysis showed that IMV days (β = − 0.736, P = 0.001), sepsis (β = − 18.111, P = 0.003) and PCIS (β = 0.550, P = 0.021) were independent risk factors for gross motor developmental dysfunction.ConclusionsGross motor developmental dysfunction in infantile and toddler PICU survivors is more common and may be exacerbated by experiences associated with longer IMV days and increasing illness severity combined with sepsis.Trial registrationThe trial ‘Early rehabilitation intervention for critically ill children’ has been registered at http://www.chictr.org.cn/showproj.aspx?proj=23132. Registration number: ChiCTR1800020196.

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“…We consider that the above risk factors leading to children's gross motor developmental dysfunction may have three pathways: 1. Prolonged mechanical ventilation and sepsis can lead to limb muscle atrophy [42,43] , resulting in weakened muscle strength in children; thus, abnormal assessment results may be due to weakened muscle strength; 2. Studies have confirmed that sepsis and IMV can cause brain dysfunction [44,45] .…”

Section: Discussionmentioning

confidence: 99%

Gross Motor Developmental Function Outcomes in Infantile and Toddler Pediatric Intensive Care Unit Survivors

Yang

Feng

et al. 2019

Preprint

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Background In recent years, increasing studies have focused on motor function/dysfunction in PICU survival. However, most studies have focused on adults and older children. This study aims to investigate gross motor developmental function outcomes in infantile and toddler pediatric intensive care unit (PICU) survivors and the factors associated with gross motor developmental functions.Methods Thirty-five eligibles were divided into dysfunctional (n=24) or non-dysfunctional (n=11) group. Baseline gross motor function for all participants before PICU admission was measured via the Age and Stages Questionnaires, Third Edition (ASQ-3). The Peabody Developmental Motor Scales, Second Edition (PDMS-2) was used to evaluate gross motor development function before PICU discharge.Results The gross motor developmental dysfunction incidence was 68.6% in this study. Linear correlation analysis showed that the GMQ was positively correlated with pediatric critical illness score (PCIS, r=0.621, P<0.001), and negatively correlated with length of PICU stay (r=-0.556, P=0.001), days sedated (r=-0.602, P<0.001), days on invasive mechanical ventilation (IMV; r=-0.686, P<0.001), and days on continuous renal replacement therapy (CRRT; r=-0.538, P=0.001). Linear regression analysis showed that IMV days (β=-0.736, P=0.001), sepsis (β=-18.111, P=0.003) and PCIS (β=0.550, P=0.021) were independent risk factors for gross motor developmental dysfunctionConclusions Gross motor developmental dysfunction in infantile and toddler PICU survivors are more common and may be exacerbated by experiences associated with longer IMV days and increasing illness severity combined with sepsis.

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Myopathic characteristics in septic mechanically ventilated patients

Cited by 7 publications

References 62 publications

Interrater reliability of quantitative ultrasound measures of muscle in critically ill patients

Interrater reliability of quantitative ultrasound measures of muscle in critically ill patients

Gross motor developmental dysfunctional outcomes in infantile and toddler pediatric intensive care unit survivors

Gross Motor Developmental Function Outcomes in Infantile and Toddler Pediatric Intensive Care Unit Survivors

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