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The following is a summary of “Methodologies and clinical applications of lower limb muscle ultrasound in critically ill patients: a systematic review and meta-analysis,” published in the October 2024 issue of Critical Care by Venco et al.
Patients with critical illness are frequent with reduced muscle mass and developed muscle wasting, both related to adverse outcomes, prompting the exploration of muscle ultrasound as a potential tool for muscle mass evaluation.
Researchers conducted a retrospective study summarizing lower limb muscle ultrasound values and investigating the impact of examination parameters and patient characteristics on ultrasound results.
They reviewed meta-analysis of lower limb ultrasound in patients with critical illness and searched PubMed, CINAHL, Embase, PEDro, and Web of Science. Adhering to PRISMA guidelines, studies were evaluated using the appropriate NIH quality assessment tool. A meta-analysis compared values at admission, short (≤7 days), and long (≥7 days) follow-up during ICU stay. Meta-regression examined the association between baseline values and patient characteristics or ultrasound parameters.
The results showed that 66 studies (3,839 patients) were included. The primary muscles assessed were rectus femoris cross-sectional area (RF-CSA, n = 33/66), quadriceps muscle layer thickness (n = 32/66), and rectus femoris thickness (n = 19/66). Significant variations were observed in the anatomical landmark and ultrasound settings. At ICU admission, RF-CSA ranged from 1.1 [0.73–1.47] to 6.36 [5.45–7.27] cm2 (pooled average 2.83 [2.29–3.37] cm2) with high heterogeneity among studies (I2= 98.43%). Higher age, higher BMI, a more distal landmark, and the use of probe compression were associated with lower baseline muscle mass.
They concluded the muscle mass measurements with ultrasound variations were based on patient characteristics, position, anatomical landmarks, and probe compression.
Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01395-y
