Muscle Mass Loss in Mechanically Ventilated Critically Ill Patients in Intensive Care Unit

Background. Muscle mass can be an important predictor for survival in critical illness, and there is no universally acknowledged approach for routinely assessing low muscu-larity at ICU admission. We aimed to identify patients with low muscularity and inves-tigate whether ultrasound muscle mass measurements changed during the ICU stay. Materials and methods. We performed a retrospective analysis of the ultrasound data of patients admitted with septic shock and sepsis in the ICU. We included patients who underwent ultrasound measurements of the quadriceps femoris muscle thickness including the rectus femoris and vastus intermedius. Weight and ultrasound measure-ments were performed on days 1, 3, 5, and 7 of the ICU stay. Results. The study group comprised 61% (n = 14) males and 39% (n = 9) females with a mean age group of 63.74 +/- 10.97 years. The mean APACHE score was 16.0 +/- 2.38. The mean admission weight was 62.2 +/- 16.6 and the recorded weight on day 7 was 59.4 +/- 15.7 wherein the reduction in weight was statistically significant (p < 0.01). Muscle mass thickness measurements of rectus femoris reduced from 1.44 +/- 0.34 cm on day 1 to 1.22 +/- 0.33 cm on day 7 which was statistically significant (p = 0.002). Similarly, muscle mass measurements of the vastus intermedius reduced significantly from 1.23 +/- 0.48 cm on day 1 to 0.97 +/- 0.36 cm on day 7 with p = 0.035.Conclusions. Ultrasound measurements of the quadriceps muscle layer thickness can be used to detect low and reduced muscularity. Strategies involving both adequacies of nutrition and timely rehabilitation and mobility can prove beneficial in lowering muscle loss in hospitalized critically ill patients.