1. Ultrasonography and Other Nutrition Assessment Methods to Monitor the Nutrition Status of Critically Ill Patients
- Author
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Álida Rosária Silva Ferreira, Jessimara Ribeiro Henrique, Maria Isabel Toulson Davisson Correia, and Camila Neves Rodrigues
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,030309 nutrition & dietetics ,medicine.medical_treatment ,Critical Illness ,Medicine (miscellaneous) ,Nutritional Status ,Thigh ,03 medical and health sciences ,0302 clinical medicine ,Intensive care ,medicine ,Humans ,Critical Care Outcomes ,Ultrasonography ,Mechanical ventilation ,0303 health sciences ,Nutrition and Dietetics ,business.industry ,medicine.disease ,Adductor pollicis muscle ,Malnutrition ,Intensive Care Units ,medicine.anatomical_structure ,Nutrition Assessment ,Physical therapy ,030211 gastroenterology & hepatology ,Observational study ,business - Abstract
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.
- Published
- 2020