Evaluation of Sarcopenia by Ultrasound of the Rectus Femoris Muscle as a Predictor of Outcomes of Surgical Intensive Care Unit Patients, A Prospective, Observational Study

Background: Muscle wasting is a frequent finding in critically ill patients and is associated with worse short- and long term outcomes. Loss of mass and function of skeletal muscles starts early - in the first 24 hours after admission to Intensive Care Unit (ICU) - and may persist for years ‘Post-ICU syndrome’. Ultrasound of rectus femoris muscle is a valid and simple technique that could be used for longitudinal assessment of treatment success and facilitates the use of postoperative interventions that help in problems related to critical illness. The aim of this study is to evaluate sarcopenia by ultrasound of rectus femoris muscle as a predictor of outcomes of surgical intensive care unit.

Materials and Methods: This prospective observational study was performed on 40 patients admitted to the surgical ICU, Tanta University Hospitals, Egypt, after approval of the Institutional Ethical Committee, Tanta University. The study started from April 2019 till January 2020. An informed consent was taken from the nearest relatives of the patients. All data of the patients was confidential with secret codes and private files for each patient. All given data was used for the current medical research only. Any unexpected risks appeared during the course of the research were cleared to the participants and ethical committee at time.

Results: Cross-sectional area of rectus femoris muscle decreased significantly at all-time measurements as compared to the baseline at day 0 (within 24 hours from SICU admission), 5, 10, 15, 20, 25 and 30. There were negative correlations between delta cross-sectional area of rectus femoris muscle and age, height, weight, Body Mass Index and baseline cross-sectional area of rectus femoris muscle. There was a positive correlation between delta cross-sectional area of rectus femoris muscle and duration of mechanical ventilation, ICU length of stay and mortality.

Conclusion: Rectus femoris cross-sectional area measured by B-mode ultrasonography showed significant role in nutritional assessment as it decreases in critically ill patients with positive correlation with duration of mechanical ventilation and ICU stay.