An Analysis of Reliability and Accuracy of Muscle Thickness Ultrasonography in Critically Ill Children and Adults

JPEN. Journal of Parenteral and Enteral Nutrition
Tom FivezDieter Mesotten

Abstract

Muscle wasting starts already within the first week in critically patients and is strongly related to poor outcome. Nevertheless, the early detection of muscle wasting is difficult. Therefore, we investigated the reliability and accuracy of ultrasonography to evaluate skeletal muscle wasting in critically ill children and adults. This prospective observational study enrolled 30 sedated critically ill children and 14 critically ill adults. Two independent investigators made 210 ultrasonographical assessments of muscle thigh thickness. Inter- and intraobserver reliability and cutoff levels were calculated as a function of muscle thickness and the expected reduction in muscle size (predefined at 20% and 30%). Mean ± SD muscle thickness was 1.67 ± 0.55 cm in the pediatric and 2.10 ± 0.85 cm in the adult population. The median absolute interobserver variability was 0.07 cm (interquartile range [IQR], 0.04-0.20 cm) in the pediatric population and 0.05 cm (IQR, 0.03-0.09 cm) in the adult population. However, the absolute intraobserver accuracy had a 95% confidence interval of 0.43 cm in children and 0.22 cm in adults. Only a 30% decrease (0.50 cm) in muscle thickness can be detected in critically ill children. Although the interobserv...Continue Reading

References

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Citations

Oct 4, 2015·Journal of the Neurological Sciences·Kay W NgCraig M Zaidman
Mar 11, 2016·JPEN. Journal of Parenteral and Enteral Nutrition·Michael T ParisDaren K Heyland
May 27, 2017·Current Opinion in Critical Care·Nicolas TardifOlav Rooyackers
Jun 27, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Frederic V VallaNazima Pathan
Aug 11, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·David B Kantor, Nilesh M Mehta
May 31, 2018·Current Opinion in Critical Care·Wilhelmus G P M LooijaardPeter J M Weijs
Nov 24, 2018·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Zheng-Yii Lee, Daren K Heyland
May 29, 2018·Journal of Nutrition and Metabolism·Carlos Alfredo Galindo MartínOctavio Augusto Lescas Méndez
Oct 8, 2017·Annals of Intensive Care·Maria Giuseppina AnnettaMassimo Antonelli
Jan 17, 2021·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Elisabeth De WaelePaul E Wischmeyer
Aug 16, 2017·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Vijay HaddaRandeep Guleria
Aug 7, 2021·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Ruane S de FigueiredoTiago H de Souza
Aug 22, 2021·Ultrasound in Medicine & Biology·Taís Silva NascimentoMansueto Gomes-Neto
May 25, 2021·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Robert M HoffmannDavid B Kantor

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Clinical Trials Mentioned

NCT01536275

Software Mentioned

MATLAB

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