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. 2024 Feb 27;14(1):4811.
doi: 10.1038/s41598-024-55118-1.

Association of tissue oxygen saturation levels with skeletal muscle injury in the critically ill

Ryuji Sugiya  1   2 , Shinichi Arizono  2 , Yuji Higashimoto  1 , Yuta Kimoto  1 , Masashi Shiraishi  1 , Hiroki Mizusawa  1 , Yuichi Tawara  2 , Hironori Shigeoka  3 , Jan Bakker  4   5   6   7 , Koichiro Shinozaki  8   9
Affiliations

Association of tissue oxygen saturation levels with skeletal muscle injury in the critically ill

Ryuji Sugiya et al. Sci Rep. .

Abstract

This study aimed to investigate the association between the level of tissue oxygen saturation (StO2) and quadriceps/skeletal muscle dysfunction, measured using the Medical Research Council (MRC) scale and ultrasonography, in critically ill patients. Thirty-four patients hospitalized at the Critical Care Medicine Center of Kindai University Hospital, between January 2022 and March 2023, were enrolled in this study. The StO2 of the quadriceps muscle was measured via near-infrared spectroscopy. Muscle atrophy was measured by the thickness, cross-sectional area (CSA), and echo intensity of the rectus femoris (RF). These values were evaluated every alternate day until 13 days after admission or until discharge, whichever occurred first. Muscle weakness was assessed using the sum score of the MRC scale (MRC-SS), with the patient sitting at bedside. The mean age of the patients was 67.3 ± 15.3 years, and 20 (59%) were men. Seven patients (21%) were admitted for trauma, and 27 (79%) were admitted for medical emergencies or others. The mean score for the MRC-SS was 51.0 ± 7.9 points. RF thickness and CSA significantly decreased after day 7 (p < 0.05). There were no significant changes in StO2 levels during hospitalization. However, there were positive correlations between the nadir StO2 during hospitalization and MRC-SS, and changes in RF thickness and CSA at discharge (r = 0.41, p = 0.03; r = 0.37, p = 0.03; and r = 0.35, p = 0.05, respectively). StO2 in the quadriceps muscle may be useful for predicting muscle atrophy and dysfunction in patients with critical illnesses.

Keywords: Cross-sectional area; Medical Research Council (MRC) scale; Near-infrared spectroscopy; Rectus femoris; Tissue oxygen saturation; Ultrasonography.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Measurement by the BOM-L1TRW laser tissue oximeter (OmegaWave, Inc., Tokyo, Japan). (a) A picture of the near-infrared spectroscopy (NIRS) system. (b) The NIRS probe was placed over the quadriceps muscle of the patient’s dominant side (1/3 of the distance from the greater trochanter to the middle border of the patella).
Figure 2
Figure 2
Flowchart of patient inclusion.
Figure 3
Figure 3
Change in StO2 over time during the hospitalization. StO2: tissue oxygen saturation.
Figure 4
Figure 4
Correlation between nadir StO2 and percentage change in RF thickness at discharge (admission to ICU – > discharge from ICU). StO2: tissue oxygen saturation, RF: rectus femoris.
Figure 5
Figure 5
Correlation between nadir StO2 and percentage change in the rectus femoris CSA at discharge (admission to ICU – > discharge from ICU). StO2: tissue oxygen saturation, CSA: cross-sectional area.
See this image and copyright information in PMC

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