Point of care ultrasonography of quadriceps femoris muscle thickness for assessing nutritional status in critically ill children

Abstract

Muscle wasting occurs early during critical illness. It is associated with poor PICU outcomes. Ultrasonography can detect muscle thickness in critically ill children. Study quadriceps muscle thickness to assess the nutritional status on admission and follow the muscle thickness change throughout the first week of admission in PICU using point-of-care ultrasonography. This cohort study was conducted on 55 critically ill mechanically ventilated children aged between 2 months and 14 years. Serial measurements of quadriceps muscle thickness were done by ultrasound, during the first week of admission. Quadriceps muscle thickness decreased by 16.4% over the 1st week of admission. The muscle wasting was significantly correlated with STRONGkids score, the inability to achieve target caloric requirements during the 1st week of admission, duration of ventilation, PRISM score, and mortality. Point of care ultrasonography is an easy tool for assessing PICU muscle wasting. Loss of muscle mass during the first week of PICU admission is correlated to mortality, thus it can be utilized in predicting PICU outcomes.

Keywords: Critically ill; Mortality; Quadriceps; Ultrasonography.

Fig. 1

Histogram of the percentage of muscle wasting over the first week of admission.

Fig. 2

ROC curve for discrimination between survivors and non-survivors using the percent of muscle wasting.