Correlation between weaning outcome of patients on prolonged mechanical ventilation and changes in skeletal muscles as assessed by ultrasonography

Abstract

Background Skeletal muscle atrophy develops in severely sick patients, whereas decreased muscle mass is usually linked to poorer clinical outcomes. Peripheral muscle ultrasound (US) can be used to evaluate muscle atrophy. Objective We conducted this study to investigate the use of US in the assessment of changes in skeletal muscle mass in cases with prolonged mechanical ventilation (MV) and to correlate these changes with weaning outcomes. Patients and methods This cross-sectional observational study recruited patients on MV for 7 days or more in respiratory ICUs of Ain Shams University Hospitals between January 2019 and March 2021. US evaluation of quadriceps muscle was done on day 1, day 7, and weekly thereafter till weaning from MV. Results In all, 81 patients were scanned on day 1 and day 7 of MV; 43 patients were reevaluated on day 14, and three patients were reevaluated on day 21. A significant reduction of rectus femoris surface area as well as the thickness of vastus intermedius has been detected at day 7 and at day 14 of MV. There was a highly significant correlation between the percent of change of rectus femoris muscle surface area and weaning outcome. Conclusion US can monitor changes in muscle mass in patients on prolonged MV. Quadriceps muscle mass evaluated by US demonstrated a tendency to reduce in cases with prolonged MV and is linked to poorer weaning outcomes.

Keywords

• quadriceps muscles
• skeletal muscle ultrasound
• weaning outcome