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Background This study aims to evaluate the use of ultrasonography (US) as an instrument to assess the quadriceps muscles in patients admitted to intensive care units (ICUs), comparing the evolution of US-assessed mass muscle to other nutrition methods. Methods We conducted a prospective observational study of adult patients aged ≥18 years admitted to an ICU of the Hospital das Clinicas in Brazil. Quadriceps muscle measurements were performed by US, and adductor pollicis muscle thickness and arm, calf, and thigh circumferences were measured at admission and every 2 days within the first week. Nutrition status was assessed at baseline by using the Subjective Global Assessment and the Global Leadership Initiative on Malnutrition criteria. Mechanical ventilation time, length of hospital and ICU stay, and mortality were recorded. Results Sixty patients were included. Reductions in quadriceps thickness and rectus femoris cross-sectional area were observed at landmarks two-thirds reduction of both measurements from days 1 and 3 to days 5 and 7 (P = .017 and P = .000, respectively). The mid arm circumference (MAC) was reduced. Malnourished patients had lower initial muscle mass. However, muscle mass loss was similar between nourished and malnourished individuals (P > .005). Clinical outcomes were not impacted by muscle loss. Conclusions US muscle mass assessment was able to detect short-term changes in critically ill patients but must be used with caution. MAC was also identified as a useful follow-up tool.

Objective The aim of this study was to evaluate the relevance of ultrasonography training by non-experts carrying out quadriceps muscle mass assessment. Methods Two non-expert evaluators were trained by two radiologists on the basic principles of ultrasonography and quadriceps muscle measurements. Afterward, they performed assessments on 30 healthy volunteers to determine interobserver agreement, considering two landmarks (two-thirds of the femoral distance, and 10 cm above the patella), which were tested by the intraclass correlation coefficient (ICC). Results In all, 342 measurements were acquired. Better ICC data were seen for the muscle at two-thirds (ICC = 0.74–0.86) of the landmark than at the 10-cm landmark (ICC = 0.63–0.91). However, the thickness measurements indicated inadequate agreement (ICC = 0.71). The ICC values for both the rectus femoris area and thickness progressively increased when comparing the first 10 measurements with the last 10 for the two-thirds landmark. For the 10-cm landmark, worse data were observed in the last measurements, perhaps due to the increased number of obese volunteers. Conclusions Measurements at the 10-cm landmark are more difficult to acquire, especially in the obese. Intensive training for non-expert examiners is mandatory.