Journal
PEDIATRIC CRITICAL CARE MEDICINE
Volume 22, Issue 10, Pages 889-897Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PCC.0000000000002747
Keywords
muscle; nutrition; point-of-care ultrasound; quadriceps femoris
Categories
Funding
- Department of Anesthesiology, Critical Care and Pain Medicine at Boston Children's Hospital
- Fred Lovejoy Award from the Department of Medicine at Boston Children's Hospital
Ask authors/readers for more resources
This study aims to evaluate the reliability of ultrasound in measuring quadriceps femoris muscle thickness in critically ill children and to explore its relationship with fluid balance and nutritional intake. The results show that ultrasound measurements of quadriceps femoris muscle thickness are reliable and associated with nutritional intake.
OBJECTIVES: Evaluate the reliability of ultrasound to measure quadriceps femoris muscle thickness in critically ill children and to describe serial changes in quadriceps femoris muscle thickness in relation to fluid balance and nutritional intake. DESIGN: Prospective observational study. SETTING: Tertiary care children's hospital. PATIENTS: Inpatients age 3 months to 18 years recently admitted to the ICU who were sedated and mechanically ventilated at the time of the first ultrasound scan. METHODS: Prospective observational study to examine the reliability of averaged ultrasound measurements of quadriceps femoris muscle thickness. Change in average quadriceps femoris muscle thickness over time was correlated with fluid balance and nutritional intake. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Averaged quadriceps femoris muscle thickness demonstrated good to excellent reliability when comparing pediatric critical care providers to pediatric radiologists and when comparing between different pediatric critical care providers. We found no significant association between fluid balance over 1 or 3 days and change in quadriceps femoris muscle thickness over the same time frame. However, there was a significant association between percent of goal calories (p < 0.001) or percent of goal protein (p < 0.001) over 6 days and change in quadriceps femoris muscle thickness over the same time frame. CONCLUSIONS: Averaged ultrasound measurements of quadriceps femoris muscle thickness demonstrate good to excellent reliability, are not confounded by fluid balance, and are useful for tracking changes in muscle thickness that are associated with nutritional intake. Ultrasound-based assessment of quadriceps femoris is a clinically useful tool for evaluating muscle mass and may be a proxy for nutritional status.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available