Sonographic muscle mass assessment in patients after cardiac surgery  

作　　者：Stavros Dimopoulos Vasiliki Raidou Dimitrios Elaiopoulos Foteini Chatzivasiloglou Despoina Markantonaki Efterpi Lyberopoulou Ioannis Vasileiadis Katerina Marathias Serafeim Nanas Andreas Karabinis 

机构地区：[1]Department of Cardiac Surgery ICU,Onassis Cardiac Surgery Center,Athens 17674,Greece [2]Clinical Ergospirometry,Exercise and Rehabilitation Laboratory,National and Kapodistrian University of Athens,Athens 10676,Greece

出　　处：《World Journal of Cardiology》2020年第7期351-361,共11页世界心脏病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Patients undergoing cardiac surgery particularly those with comorbidities and frailty,experience frequently higher rates of post-operative morbidity,mortality and prolonged hospital length of stay.Muscle mass wasting seems to play important role in prolonged mechanical ventilation(MV)and consequently in intensive care unit(ICU)and hospital stay.AIM To investigate the clinical value of skeletal muscle mass assessed by ultrasound early after cardiac surgery in terms of duration of MV and ICU length of stay.METHODS In this observational study,we enrolled consecutively all patients,following their admission in the Cardiac Surgery ICU within 24 h of cardiac surgery.Bedside ultrasound scans,for the assessment of quadriceps muscle thickness,were performed at baseline and every 48 h for seven days or until ICU discharge.Muscle strength was also evaluated in parallel,using the Medical Research Council(MRC)scale.RESULTS Of the total 221 patients enrolled,ultrasound scans and muscle strength assessment were finally performed in 165 patients(patients excluded if ICU stay<24 h).The muscle thickness of rectus femoris(RF),was slightly decreased by 2.2%[(95%confidence interval(CI):-0.21 to 0.15),n=9;P=0.729]and the combined muscle thickness of the vastus intermedius(VI)and RF decreased by 3.5%[(95%CI:-0.4 to 0.22),n=9;P=0.530].Patients whose combined VI and RF muscle thickness was below the recorded median values(2.5 cm)on day 1(n=80),stayed longer in the ICU(47±74 h vs 28±45 h,P=0.02)and remained mechanically ventilated more(17±9 h vs 14±9 h,P=0.05).Moreover,patients with MRC score≤48 on day 3(n=7),required prolonged MV support compared to patients with MRC score≥49(n=33),(44±14 h vs 19±9 h,P=0.006)and had a longer duration of extracorporeal circulation was(159±91 min vs 112±71 min,P=0.025).CONCLUSION Skeletal quadriceps muscle thickness assessed by ultrasound shows a trend to a decrease in patients after cardiac surgery post-ICU admission and is associated with prolonged duration of MV and ICU length of

关 键 词：Intensive care unit-acquired weakness Cardiac surgery Skeletal muscle wasting Muscle ultrasound Quadriceps femoris Muscle mass 

分 类 号：R654.2[医药卫生—外科学]