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Ultrasound weakness critical ill

Peter Turton, Richard Hay, Jonathon Taylor, Jamie McPhee, Ingeborg Welters
BACKGROUND: Critically ill patients frequently suffer muscle weakness whilst in critical care. Ultrasound can reliably track loss of muscle size, but also quantifies the arrangement of the muscle fascicles, known as the muscle architecture. We sought to measure both pennation angle and fascicle length, as well as tracking changes in muscle thickness in a population of critically ill patients. METHODS: On days 1, 5 and 10 after admission to critical care, muscle thickness was measured in ventilated critically ill patients using bedside ultrasound...
November 29, 2016: BMC Anesthesiology
E Segaran, L Wandrag, M Stotz, M Terblanche, M Hickson
BACKGROUND: Critical illness is associated with muscle loss, weakness and poor recovery. The impact that illness and the ensuing metabolic response has on obese patients is not known. Objectives were to test if obese patients lose less muscle depth compared to non-obese patients; if a reduction in muscle depth was associated with reduced strength and recovery; and to assess the feasibility of these methods with a range of body mass index's (BMI). METHODS: A prospective observational pilot study of muscle depth in critically ill patients categorised by BMI was performed...
August 1, 2016: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
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No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Alexander Levitov, Heidi L Frankel, Michael Blaivas, Andrew W Kirkpatrick, Erik Su, David Evans, Douglas T Summerfield, Anthony Slonim, Raoul Breitkreutz, Susanna Price, Matthew McLaughlin, Paul E Marik, Mahmoud Elbarbary
OBJECTIVE: To establish evidence-based guidelines for the use of bedside cardiac ultrasound, echocardiography, in the ICU and equivalent care sites. METHODS: Grading of Recommendations, Assessment, Development and Evaluation system was used to rank the "levels" of quality of evidence into high (A), moderate (B), or low (C) and to determine the "strength" of recommendations as either strong (strength class 1) or conditional/weak (strength class 2), thus generating six "grades" of recommendations (1A-1B-1C-2A-2B-2C)...
June 2016: Critical Care Medicine
Michele Umbrello, Paolo Formenti
The majority of patients admitted to the ICU require mechanical ventilation as a part of their process of care. However, mechanical ventilation itself or the underlying disease can lead to dysfunction of the diaphragm, a condition that may contribute to the failure of weaning from mechanical ventilation. However, extended time on the ventilator increases health-care costs and greatly increases patient morbidity and mortality. Nevertheless, symptoms and signs of muscle disease in a bedridden (or bed rest-only) ICU patient are often difficult to assess because of concomitant confounding factors...
April 2016: Respiratory Care
Paul E Wischmeyer, Inigo San-Millan
Over the last 10 years we have significantly reduced hospital mortality from sepsis and critical illness. However, the evidence reveals that over the same period we have tripled the number of patients being sent to rehabilitation settings. Further, given that as many as half of the deaths in the first year following ICU admission occur post ICU discharge, it is unclear how many of these patients ever returned home. For those who do survive, the latest data indicate that 50-70% of ICU "survivors" will suffer cognitive impairment and 60-80% of "survivors" will suffer functional impairment or ICU-acquired weakness (ICU-AW)...
2015: Critical Care: the Official Journal of the Critical Care Forum
Colin Anthony Francis, Joaquín Andrés Hoffer, Steven Reynolds
BACKGROUND: Mechanical ventilation is associated with atrophy and weakness of the diaphragm. Ultrasound is an easy noninvasive way to track changes in thickness of the diaphragm. OBJECTIVE: To validate ultrasound as a means of tracking thickness of the diaphragm in patients undergoing mechanical ventilation by evaluating interobserver and interoperator reliability and to collect initial data on the relationship of mode of ventilation to changes in the diaphragm...
January 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
Noomi Mueller, Sushila Murthy, Christopher R Tainter, Jarone Lee, Kathleen Riddell, Florian J Fintelmann, Stephanie D Grabitz, Fanny P Timm, Benjamin Levi, Tobias Kurth, Matthias Eikermann
OBJECTIVE: To compare sarcopenia and frailty for outcome prediction in surgical intensive care unit (SICU) patients. BACKGROUND: Frailty has been associated with adverse outcomes and describes a status of muscle weakness and decreased physiological reserve leading to increased vulnerability to stressors. However, frailty assessment depends on patient cooperation. Sarcopenia can be quantified by ultrasound and the predictive value of sarcopenia at SICU admission for adverse outcome has not been defined...
December 2016: Annals of Surgery
Suzie Ferrie, Margaret Allman-Farinelli, Mark Daley, Kristine Smith
BACKGROUND: Current recommendations for higher protein/amino acid provision in the critically ill are based on weak evidence. This double-blinded randomized controlled trial aimed to compare standard amino acid intake with the higher level recommended as the minimum for critically ill patients. METHODS: In total, 119 patients requiring parenteral nutrition (PN) in an intensive care unit (ICU) were randomized to receive blinded PN solutions containing amino acids at either 0...
August 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Heidi L Frankel, Andrew W Kirkpatrick, Mahmoud Elbarbary, Michael Blaivas, Himanshu Desai, David Evans, Douglas T Summerfield, Anthony Slonim, Raoul Breitkreutz, Susanna Price, Paul E Marik, Daniel Talmor, Alexander Levitov
OBJECTIVE: To establish evidence-based guidelines for the use of bedside ultrasound by intensivists and specialists in the ICU and equivalent care sites for diagnostic and therapeutic purposes for organs of the chest, abdomen, pelvis, neck, and extremities. METHODS: The Grading of Recommendations, Assessment, Development and Evaluation system was used to determine the strength of recommendations as either strong or conditional/weak and to rank the "levels" of quality of evidence into high (A), moderate (B), or low (C) and thus generating six "grades" of recommendation (1A-1B-1C-2A-2B-2C)...
November 2015: Critical Care Medicine
Hsuan-Yu Chen, Hung-Chen Chen, Meng-Chih Lin, Mei-Yun Liaw
Bilateral diaphragmatic paralysis (BDP) manifests as respiratory muscle weakness, and its association with critical illness polyneuropathy (CIP) was rarely reported. Here, we present a patient with BDP related to CIP, who successfully avoided tracheostomy after diagnosis and management.A 71-year-old male presented with acute respiratory failure after sepsis adequately treated. Repeated intubation occurred because of carbon dioxide retention after each extubation. After eliminating possible factors, septic shock-induced respiratory muscle weakness was suspected...
August 2015: Medicine (Baltimore)
Ewan C Goligher, Eddy Fan, Margaret S Herridge, Alistair Murray, Stefannie Vorona, Debbie Brace, Nuttapol Rittayamai, Ashley Lanys, George Tomlinson, Jeffrey M Singh, Steffen-Sebastian Bolz, Gordon D Rubenfeld, Brian P Kavanagh, Laurent J Brochard, Niall D Ferguson
RATIONALE: Diaphragm atrophy and dysfunction have been reported in humans during mechanical ventilation, but the prevalence, causes, and functional impact of changes in diaphragm thickness during routine mechanical ventilation for critically ill patients are unknown. OBJECTIVES: To describe the evolution of diaphragm thickness over time during mechanical ventilation, its impact on diaphragm function, and the influence of inspiratory effort on this phenomenon. METHODS: In three academic intensive care units, 107 patients were enrolled shortly after initiating ventilation along with 10 nonventilated intensive care unit patients (control subjects)...
November 1, 2015: American Journal of Respiratory and Critical Care Medicine
Aaron Bunnell, John Ney, Alfred Gellhorn, Catherine L Hough
Intensive care unit-acquired weakness (ICU-AW) causes significant morbidity and impairment in critically ill patients. Recent advances in neuromuscular ultrasound (NMUS) allow evaluation of neuromuscular pathology early in critical illness. Here we review application of ultrasound in ICU-AW. MEDLINE-indexed articles were searched for terms relevant to ultrasound and critical illness. Two reviewers evaluated the resulting abstracts (n = 218) and completed full-text review (n = 13). Twelve studies and 1 case report were included...
November 2015: Muscle & Nerve
Susannah A A Bloch, Anna V J Donaldson, Amy Lewis, Winston A S Banya, Michael I Polkey, Mark J D Griffiths, Paul R Kemp
INTRODUCTION: Acute muscle wasting in the critically ill is common and associated with significant morbidity and mortality. Although some aetiological factors are recognised and muscle wasting can be detected early with ultrasound, it not possible currently to predict in advance of muscle loss those who will develop muscle wasting. The ability to stratify the risk of muscle wasting associated with critical illness prior to it becoming clinically apparent would provide the opportunity to predict prognosis more accurately and to intervene at an early stage...
April 7, 2015: Critical Care: the Official Journal of the Critical Care Forum
Claire E Baldwin, Andrew D Bersten
BACKGROUND: Skeletal muscle wasting and weakness are common in patients with sepsis in the intensive care unit, although less is known about deficits in diaphragm and limb muscles when mechanical ventilation also is required. OBJECTIVE: The objective of this study was to concurrently investigate relative differences in both thickness and strength of respiratory and peripheral muscles during routine care. DESIGN: A prospective, cross-sectional study of 16 alert patients with sepsis and 16 people who were healthy (control group) was used...
January 2014: Physical Therapy
Dimitrios Matamis, Eleni Soilemezi, Matthew Tsagourias, Evangelia Akoumianaki, Saoussen Dimassi, Filippo Boroli, Jean-Christophe M Richard, Laurent Brochard
The use of ultrasonography has become increasingly popular in the everyday management of critically ill patients. It has been demonstrated to be a safe and handy bedside tool that allows rapid hemodynamic assessment and visualization of the thoracic, abdominal and major vessels structures. More recently, M-mode ultrasonography has been used in the assessment of diaphragm kinetics. Ultrasounds provide a simple, non-invasive method of quantifying diaphragmatic movement in a variety of normal and pathological conditions...
May 2013: Intensive Care Medicine
Susannah A A Bloch, Jen Y Lee, S John Wort, Michael I Polkey, Paul R Kemp, Mark J D Griffiths
OBJECTIVES: Acute muscle wasting in the critically ill is common and causes significant morbidity. In a novel human model of acute muscle wasting following cardiac surgery, known or potential circulating modulators of muscle mass--insulin-like growth factor-1, myostatin, and growth and differentiation factor-15--were measured over a week. It was hypothesized that patients who developed acute muscle wasting would show distinct patterns of change in these mediators. DESIGN: A prospective longitudinal observational study of high-risk elective cardiac surgical patients identifying, by ultrasound, those developing muscle wasting...
April 2013: Critical Care Medicine
Lene Terslev, Karen Ellegaard, Robin Christensen, Marcin Szkudlarek, Wolfgang A Schmidt, Peter S Jensen, Henning Bliddal, Søren Torp-Pedersen
OBJECTIVE: To evaluate the reliability and agreement of semi-quantitative scoring (SQS) and quantitative scoring (QS) systems. To compare the two types of scoring system and investigate the construct validity for both scoring systems. METHODS: A total of 46 RA patients (median disease duration of 6.5 years) were enrolled in the study. They were investigated with colour Doppler ultrasound using the central position of the wrist. Disease activity score based on 28 joints (DAS-28) was determined for all patients using CRP...
November 2012: Rheumatology
Robert D Stevens, Nicholas Hart, Bernard de Jonghe, Tarek Sharshar
Muscle weakness is prevalent in critically ill patients and can have a dramatic effect on short- and long-term outcomes, yet there are currently no interventions with proven efficacy in preventing or treating this complication. In a new randomized trial, researchers found that serial electrical muscle stimulation significantly mitigated ultrasound-defined muscle atrophy, and the treatment was not linked to adverse effects. Although preliminary, these results, together with other recent studies, indicate a paradigm shift to a proactive approach in managing neuromuscular complications in the ICU...
2009: Critical Care: the Official Journal of the Critical Care Forum
Li Wan, Natalie Yang, Chee-Yan Hiew, Anthony Schelleman, Lynne Johnson, Clive May, Rinaldo Bellomo
BACKGROUND: Knowledge of renal blood flow is considered important in the management of critically ill patients with acute renal failure. Renal Doppler ultrasound has been used to estimate renal blood flow. Its accuracy, however, has not been formally assessed. DESIGN: Prospective blinded animal study. SETTING: University physiology laboratory. SUBJECTS: Seven merino cross-ewes. INTERVENTIONS: We chronically implanted transit-time flow probes around the left renal artery and performed Doppler ultrasound measurements of RBF...
August 2008: Intensive Care Medicine
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