Reliability For Ultrasound Measurements Of Quadriceps Muscle In ICU : A Prospective Study

Introduction With growing awareness of early rehabilitation,there is a trend to develop convenient and sensitive methods of measuring change in muscle mass and function.Tracking serial changes of quadriceps muscle by bedside ultrasound is a popular way to diagnose intensive care unit–acquired weakness(ICU-AW).This study aimed to evaluate the reliability of measuring quadriceps muscle layer thickness of critically ill patients using bedside ultrasound,which can be utilized to help the clinical diagnosis of intensive care unit-acquired weakness.Methods Twenty-nine adults admitted for more than 4 days were included.Ultrasound images of cross sectional area of rectus femoris?cross sectional thickness of rectus femoris and cross sectional area of vastus intermedius were obtained in 1th day and 4th day by a registered diagnostic medical sonographer and trainees.The ICC were calculated to evaluate the reliability of each index.Results There was a progressive reduction in Rectus femoris(RF)and Vastus intermedius(VI)thickness as well as Rectus femoris CSA within the first 4 days,The rate of wasting for muscle thickness was fastest for the RF CSA(11%)compared with VI thickness(9%)and RF thickness(2%).We collected cross sectional area of rectus femoris ? cross sectional area of vastus intermedius and cross sectional thickness of rectus femoris of within operator measurements with an ICC of 0.84~0.99 in the 1th day and 4th day. There were heavily unlikeness between the trainer and trainee results in the left cross sectional area of vastus intermedius stata of the first day and left cross sectional area of rectus femoris and right rectus femoris thickness stata of the 4th day(trainer and trainee mean =-0.028 cm,95% CI =-0.067 to-0.011,P =.1607)Conclusion Bedside ultrasound is practicable to predict the outcome of the quadriceps femoris.Excellent intra-and interrater reliability for ultrasound measurements of cross sectional area of rectus femoris?cross sectional thickness of rectus femoris and cross sectional area of vastus intermedius in critically ill patients was observed.