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2018, Number 6

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Med Crit 2018; 32 (6)

Relationship between the sonographic measurement of the rectus femoris and vastus intermedius muscles and the conventional biochemical parameters used to assess the nutritional status in the intensive care unit

Hernández PAE, Gómez GMN, Soriano OR, Hernández MA, González CPL

Language: Spanish
References: 28
Page: 351-358
PDF size: 417.62 Kb.


ABSTRACT

Introduction: Malnutrition in critically ill patients is associated with poor prognosis. Protein losses are identified conventionally by biochemical parameters. The muscle mass can reflect the body protein reserve, its measurement by means of sonography has shown a strong correlation for the detection of alterations.
Objective: To determine the correlation of the sonographic measurement of the Rectus Femoris (RF) and Vastus Intermedius (VI) muscles, with the conventional biochemical parameters of nutritional assessment.
Methods: We studied 12 patients older than 18 years who received an early enteral diet. The biochemical parameters were measured, simultaneously with sonographic parameters at the level of RF and VI on days one and seven. Correlation was established between the significant biochemical and sonographic parameters.
Results: The biochemical parameter with the greatest statistical significance was the Urinary Nitrogen Balance (UNB) in a 24-hour urine sample (p = 0.001). In sonographic measurements, the percentage of muscle reduction for RF and VI showed greater difference (p = 0.001). In correlation analysis, strong correlation was obtained between UNB and RF (r = 0.77) as UNB and VI (r = 0.76).
Conclusion: There is a correlation between the protein losses measured by UNB and the percentage reduction of RF and VI muscles measured by sonography.


REFERENCES

  1. Mourão F, Amado D, Ravasco P, Vidal PM, Camilo ME. Nutritional risk and status assessment in surgical patients: a challenge amidst plenty. Nutr Hosp. 2004;19(2):83-88.

  2. Costelli P, Baccino FM. Mechanisms of skeletal muscle depletion in wasting syndromes: role of ATP-ubiquitin-dependent proteolysis. Curr Opin Clin Nutr Metab Care. 2003;6(4):407-412.

  3. Mourtzakis M, Wischmeyer P. Bedside ultrasound measurement of skeletal muscle. Curr Opin Clin Nutr Metab Care. 2014;17(5):389-395.

  4. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN.). JPEN J Parenter Enteral Nutr. 2016;40(2):159-211.

  5. Puthucheary ZA, McNelly AS, Rawal J, Connolly B, Sidhu PS, Rowlerson A, et al. Rectus femoris cross-sectional area and muscle layer thickness: comparative markers of muscle wasting and weakness. Am J Respir Crit Care Med. 2017;195(1):136-138.

  6. Costa-Moreira O, Patrocinio de Oliveira CE, Candia-Luján R, Romero-Pérez EM, de Paz-Fernández JA. Métodos de evaluación de la masa muscular: una revisión sistemática de ensayos controlados aleatorios. Nutr Hosp. 2015;32(3):977-985.

  7. Montejo-González JC, Culebras-Fernández JM, García de Lorenzo y Mateos A. Recomendaciones para la valoración nutricional del paciente crítico. Rev Méd Chile. 2006;134(8):1049-1056.

  8. Ferrie S, Tsang E. Monitoring nutrition in critical illness: what can we use? Nutr Clin Pract. 2017:884533617706312.

  9. Ferrie S, Allman-Farinelli M. Commonly used “nutrition” indicators do not predict outcome in the critically ill: a systematic review. Nutr Clin Pract. 2013;28(4):463-484.

  10. Hill GL, Witney GB, Christie PM, Church JM. Protein status and metabolic expenditure determine the response to intravenous nutrition—a new classification of surgical malnutrition. Br J Surg. 1991;78(1):109-113.

  11. Casati A, Muttini S, Leggieri C, Colombo S, Giorgi E, Torri G. Rapid turnover proteins in critically ill ICU patients. Negative acute phase proteins or nutritional indicators? Minerva Anestesiol. 1998;64(7-8):345-350.

  12. Apelgren KN, Rombeau JL, Twomey PL, Miller RA. Comparison of nutritional indices and outcome in critically ill patients. Crit Care Med. 1982;10(5):305-307.

  13. Fletcher JP, Little JM, Walker PJ. The relationship of nutritional parameters to mortality and septic complications. Aust N Z J Surg. 1986;56(12):891-895.

  14. Rogers AJ, McGeachie M, Baron RM, Gazourian L, Haspel JA, Nakahira K, et al. Metabolomic derangements are associated with mortality in critically ill adult patients. PLoS One. 2014;9(1):e87538.

  15. Luiking YC, Poeze M, Ramsay G, Deutz NE. The role of arginine in infection and sepsis. JPEN J Parenter Enteral Nutr. 2005;29(1 Suppl):S70-S74.

  16. Askanazi J, Carpentier YA, Michelsen CB, Elwyn DH, Furst P, Kantrowitz LR, et al. Muscle and plasma amino acids following injury. Influence of intercurrent infection. Ann Surg. 1980;192(1):78-85.

  17. Ballesteros M, Cortes A, Arleaga CI, Puerto R, Bojac B. The usefulness of serum creatinine levels in identifying hospital malnutrition. Nutr Hosp. 1994;9(3):186-196.

  18. Cheatham ML, Safcsak K, Brzezinski SJ, Lube MW. Nitrogen balance, protein loss, and the open abdomen. Crit Care Med. 2007;35(1):127-131.

  19. Brockmann K, Becker P, Schreiber G, Neubert K, Brunner E, Bönnemann C. Sensitivity and specificity of qualitative muscle ultrasound in assessment of suspected neuromuscular disease in childhood. Neuromuscul Disord. 2007;17(7):517-523.

  20. Pillen S, van Alfen N. Skeletal muscle ultrasound. Neurol Res. 2011;33(10):1016-1024.

  21. Kwah LK, Pinto RZ, Diong J, Herbert RD. Reliability and validity of ultrasound measurements of muscle fascicle length and pennation in humans: a systematic review. J Appl Physiol (1985). 2013;114(6):761-769.

  22. Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care. 2011;15(6):R268.

  23. Paris MT, Mourtzakis M, Day A, Leung R, Watharkar S, Kozar R, et al. Validation of bedside ultrasound of muscle layer thickness of the quadriceps in the critically ill patient (validum study). JPEN J Parenter Enteral Nutr. 2017;41(2):171-180.

  24. Pillen S, Tak RO, Zwarts MJ, Lammens MM, Verrijp KN, Arts IM, et al. Skeletal muscle ultrasound: correlation between fibrous tissue and echo intensity. Ultrasound Med Biol. 2009;35(3):443-446.

  25. Grimm A, Teschner U, Porzelius C, Ludewig K, Zielske J, Witte OW, et al. Muscle ultrasound for early assessment of critical illness neuromyopathy in severe sepsis. Crit Care. 2013;17(5):R227.

  26. Strasser EM, Draskovits T, Praschak M, Quittan M, Graf A. Association between ultrasound measurements of muscle thickness, pennation angle, echogenicity and skeletal muscle strength in the elderly. Age (Dordr). 2013;35(6):2377-2388.

  27. Annetta MG, Pittiruti M, Silvestri D, Grieco DL, Maccaglia A, La Torre MF, et al. Ultrasound assessment of rectus femoris and anterior tibialis muscles in young trauma patients. Ann Intensive Care. 2017;7(1):104.

  28. Mourtzakis M, Parry S, Connolly B, Puthucheary Z. Skeletal muscle ultrasound in critical care: a tool in need of translation. Ann Am Thorac Soc. 2017;14(10):1495-1503.




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