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Observational Study
. 2021 Oct 1;22(10):889-897.
doi: 10.1097/PCC.0000000000002747.

Ultrasound Assessment of Quadriceps Femoris Muscle Thickness in Critically Ill Children

Robert M Hoffmann  1   2 , Katelyn A Ariagno  1   3   4 , Ivy V Pham  3 , Carol E Barnewolt  5 , Delma Y Jarrett  5 , Nilesh M Mehta  3   6 , David B Kantor  3   6
Affiliations
Observational Study

Ultrasound Assessment of Quadriceps Femoris Muscle Thickness in Critically Ill Children

Robert M Hoffmann et al. Pediatr Crit Care Med. .

Abstract

Objectives: Evaluate the reliability of ultrasound to measure quadriceps femoris muscle thickness in critically ill children and to describe serial changes in quadriceps femoris muscle thickness in relation to fluid balance and nutritional intake.

Design: Prospective observational study.

Setting: Tertiary care children's hospital.

Patients: Inpatients age 3 months to 18 years recently admitted to the ICU who were sedated and mechanically ventilated at the time of the first ultrasound scan.

Methods: Prospective observational study to examine the reliability of averaged ultrasound measurements of quadriceps femoris muscle thickness. Change in average quadriceps femoris muscle thickness over time was correlated with fluid balance and nutritional intake.

Interventions: None.

Measurements and main results: Averaged quadriceps femoris muscle thickness demonstrated good to excellent reliability when comparing pediatric critical care providers to pediatric radiologists and when comparing between different pediatric critical care providers. We found no significant association between fluid balance over 1 or 3 days and change in quadriceps femoris muscle thickness over the same time frame. However, there was a significant association between percent of goal calories (p < 0.001) or percent of goal protein (p < 0.001) over 6 days and change in quadriceps femoris muscle thickness over the same time frame.

Conclusions: Averaged ultrasound measurements of quadriceps femoris muscle thickness demonstrate good to excellent reliability, are not confounded by fluid balance, and are useful for tracking changes in muscle thickness that are associated with nutritional intake. Ultrasound-based assessment of quadriceps femoris is a clinically useful tool for evaluating muscle mass and may be a proxy for nutritional status.

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Conflict of interest statement

Dr. Hoffmann’s institution received funding from the Fred Lovejoy award. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Comment in

References

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