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. 2024 Feb 12;16(1):8.
doi: 10.1186/s13089-023-00348-z.

Assessment of quadriceps muscle mass by ultrasound in the postoperative period of cardiac surgery

Nestor David Caicedo Buitrago  1   2   3 , Diana Trejos Gallego  4   5 , Maria Cristina Florián Pérez  4   5 , Carlos Andrés Quintero Cardona  6 , Cristian Chaparro Botero  6
Affiliations

Assessment of quadriceps muscle mass by ultrasound in the postoperative period of cardiac surgery

Nestor David Caicedo Buitrago et al. Ultrasound J. .

Abstract

Background: Patients undergoing cardiac surgery are exposed to many factors that activate catabolic and inflammatory pathways, which affect skeletal muscle and are, therefore, related to unfavorable hospital outcomes. Given the limited information on the behavior of muscle mass in critically ill patients, the objective of this study was to evaluate the impact on quantitative and qualitative measurements of quadriceps muscle mass using ultrasound after cardiac surgery. To accomplish this, a prospective, descriptive, and correlational study was conducted at a tertiary care hospital. Quadriceps muscle mass was evaluated via ultrasound in 31 adult patients in the postoperative period of cardiac surgery, with daily follow-up until postoperative day 7, as well as an assessment of associations with negative outcomes at 28 days.

Results: A 16% reduction in the cross-sectional area of the rectus femoris was found (95% CI 4.2-3.5 cm2; p 0.002), as well as a 24% reduction in the pennation angle of the rectus femoris (95% CI 11.1-8.4 degrees; p: 0.025). However, changes in the thickness of the rectus femoris, vastus internus, vastus lateralis, the length of the fascicle of the vastus lateralis, the pennation angle of the vastus lateralis, the sarcopenia index, and the Hekmat score were not statistically significant. There was no significant association between quadriceps muscle mass measurements and Intensive Care Unit (ICU) length stay or 28-day mortality.

Conclusions: Patients in the postoperative period of cardiac surgery evaluated by ultrasound exhibit both quantitative and qualitative changes in quadriceps muscle mass. A significant reduction in muscle mass is observed but this is not associated with unfavorable outcomes.

Keywords: Cardiac surgery; Intensive care; Quadriceps; Skeletal muscle; Ultrasound.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Assessment of quantitative and qualitative measurements of the quadriceps using ultrasound. A Measurement of the midpoint and distal third of the quadriceps, skin marking for sequential measurements, and muscle evaluation in the transverse axis with a high-frequency linear transducer. B Cross-sectional area of the rectus femoris. C Thickness of the rectus femoris and vastus internus. D Pennation angle of the rectus femoris. E Thickness and pennation angle of the vastus lateralis. F Length of the fascicle of the vastus lateralis using a linear extrapolation technique
Fig. 2
Fig. 2
Muscular mass behavior in the interdaily follow-up. RFCSA, Rectus Femoris Cross-Sectional Area; RFPA, Rectus Femoris Pennation Angle; QT, Quadriceps Thickness
See this image and copyright information in PMC

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