CO 14 – Ultrasound for the assessment of quadriceps muscle mass in critically ill patients with acute kidney injury

Autori: Sabatino A, Fani F, Napoleone F, Cantarelli C, Di Motta T, Gandolfini I, Fiaccadori E.

Affiliazioni: Renal Failure Unit, Parma University Medical School

Introduction: Muscle wasting in the ICU setting is an early effect of acute illness. Ultrasound techniques are increasingly used to evaluate muscle mass in different clinical settings. In the current study, we measured quadriceps muscle thickness (QMT) in ICU patients with acute kidney injury (AKI) (Figure 1).

Figure 1. Ultrasound measurement of rectus femoris muscle thickness (RF) and vastus intermedius muscle thickness (VI).

Methods: A prospective observational study in adult ICU patients with AKI was performed. Surgical ICU patients with normal renal function were used as controls. One assessor was responsible for measuring quadriceps rectus femoris (QRF) and vastus intermedius (QVI) thicknesses.

Results: We enrolled 59 critically ill patients with AKI (32/59 on Renal Replacement Therapy, RRT) and 40 surgical ICU patients without AKI. QRFT of patients with AKI on RRT was significantly different as compared to AKI patients not on RRT and surgical ICU patients (Table 1). No difference on QVIT was found between subgroups.

Table 1. Adjusted QRFT and QVIT of AKI (RRT and no RRT) and surgical ICU patients without AKI. Adjusted for age, sex, BMI, septic status, ICU LOS until US. AKI, Acute kidney injury; ICU, Intensive care unit; QRFT, Quadriceps rectus femoris thickness; QVIT, Quadriceps vastud intermedius thickness. * P < 0.05; # P < 0.01 in comparison to AKI RRT.

Conclusions: QMT of ICU patients with AKI needing RRT is reduced in comparison to AKI patients not on RRT and surgical ICU patients without AKI. RRT need, as a possible surrogate of illness severity, is associated with more severe muscle wasting in patients with AKI.

Lascia un commento Annulla risposta