Reliability and feasibility of skeletal muscle ultrasound in the acute burn setting.

Despite the impact of muscle wasting after burn, tools to quantify muscle wasting are lacking. This multi-centre study examined the utility of ultrasound to measure muscle mass in acute burn patients comparing different methodologies. B-mode ultrasound was used by two raters to determine feasibility and inter-rater reliability in twenty burned adults following admission. Quadriceps muscle layer thickness (QMLT) and rectus femoris cross-sectional area (RF-CSA) were measured, comparing the use of i) a single versus average measurements, ii) a proximal versus distal location for QMLT, and iii) a maximum- versus no-compression technique for QMLT. Analysis of twenty burned adults (50 years [95%CI 42–57], 32%TBSA [95%CI 23–40]) yielded ICCs of> 0.97 for QMLT (for either location and compression technique) and> 0.95 for RF-CSA, using average measurements. Relative minimal detectable changes were smaller using no-compression than maximum-compression (6.5% vs. 15%). Using no-compression to measure QMLT was deemed feasible for both proximal and distal locations (94% and 96% of attempted measurements). In 9.5% of cases maximum-compression was not feasible. 95% of RF-CSA measurements were successfully completed. Ultrasound provides feasible and reliable values of quadriceps muscle architecture that can be adapted to clinical scenarios commonly encountered in acute burn settings. [Display omitted] • Ultrasound assessment of the quadriceps is feasible at burn centre admission • This study demonstrates high inter-rater reliability and sensitivity • Ultrasound can be carried out irrespective of wound status, thigh size, oedema • Ultrasound provides a means to monitor muscle wasting throughout hospital stay [ABSTRACT FROM AUTHOR]