Chengsi Ong, Jan Hau Lee, Melvin K S Leow, Zudin A Puthucheary
{"title":"危重儿童的肌肉超声变化和身体功能:股直肌横截面积和股四头肌厚度测量的比较。","authors":"Chengsi Ong, Jan Hau Lee, Melvin K S Leow, Zudin A Puthucheary","doi":"10.1097/CCE.0000000000000937","DOIUrl":null,"url":null,"abstract":"<p><p>Quadriceps thickness (QT) and rectus femoris cross-sectional area (RF<sub>CSA</sub>) are both used to evaluate muscle changes in critically ill children. However, their correlation and association with physical function has not been compared.</p><p><strong>Objectives: </strong>To compare QT with RF<sub>CSA</sub> changes, and their association with physical function in critically ill children.</p><p><strong>Design setting and participants: </strong>Secondary analysis of a prospective cohort study of children 0-18 years old admitted to a tertiary mixed PICU between January 2015 and October 2018 with PICU stay greater than 48 hours and greater than or equal to one organ dysfunction.</p><p><strong>Main outcomes and measures: </strong>Ultrasound QT and RF<sub>CSA</sub> were measured at PICU admission, PICU discharge, hospital discharge, and 6 months post-discharge. QT and RF<sub>CSA</sub> changes from baseline were compared with each other and with change in motor function, physical ability, and physical health-related quality of life (HRQOL).</p><p><strong>Results: </strong>Two hundred thirty-seven images from 66 subjects were analyzed. RF<sub>CSA</sub> change was not significantly different from QT change at PICU (-8.07% [interquartile range (IQR), -17.11% to 4.80%] vs -4.55% [IQR, -14.32% to 4.35%]; <i>p</i> = 0.927) or hospital discharge (-5.62% [IQR, -15.00% to 9.42%] vs -8.81% [IQR, -18.67% to 2.39%]; <i>p</i> = 0.238) but was significantly greater than QT change at 6 months (32.7% [IQR, 5.74-109.76%] vs 9.66% [IQR, -8.17% to 25.70%]; <i>p</i> < 0.001). Motor function change at PICU discharge was significantly associated with RF<sub>CSA</sub> change (adjusted β coefficient, 0.02 [95% CI, 0.01-0.03]; <i>p</i> = 0.013) but not QT change (adjusted β coefficient, -0.01 [95% CI, -0.02 to 0.01]; <i>p</i> = 0.415). Similar results were observed for physical HRQOL changes at hospital discharge (adjusted β coefficient for RF<sub>CSA</sub> change, 0.51 [95% CI, 0.10-0.92]; <i>p</i> = 0.017 and adjusted β coefficient for QT change, -0.21 [-0.76 to 0.35]; <i>p</i> = 0.458). Physical ability was not significantly associated with RFCSA or QT changes at 6 months post-discharge.</p><p><strong>Conclusions and relevance: </strong>Ultrasound derived RF<sub>CSA</sub> is associated with PICU motor function and hospital discharge physical HRQOL changes, unlike QT, and may be more useful for in-hospital muscle monitoring in critically ill children.</p>","PeriodicalId":10759,"journal":{"name":"Critical Care Explorations","volume":"5 6","pages":"e0937"},"PeriodicalIF":0.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/09/cc9-5-e0937.PMC10281326.pdf","citationCount":"0","resultStr":"{\"title\":\"Muscle Ultrasound Changes and Physical Function of Critically Ill Children: A Comparison of Rectus Femoris Cross-Sectional Area and Quadriceps Thickness Measurements.\",\"authors\":\"Chengsi Ong, Jan Hau Lee, Melvin K S Leow, Zudin A Puthucheary\",\"doi\":\"10.1097/CCE.0000000000000937\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Quadriceps thickness (QT) and rectus femoris cross-sectional area (RF<sub>CSA</sub>) are both used to evaluate muscle changes in critically ill children. However, their correlation and association with physical function has not been compared.</p><p><strong>Objectives: </strong>To compare QT with RF<sub>CSA</sub> changes, and their association with physical function in critically ill children.</p><p><strong>Design setting and participants: </strong>Secondary analysis of a prospective cohort study of children 0-18 years old admitted to a tertiary mixed PICU between January 2015 and October 2018 with PICU stay greater than 48 hours and greater than or equal to one organ dysfunction.</p><p><strong>Main outcomes and measures: </strong>Ultrasound QT and RF<sub>CSA</sub> were measured at PICU admission, PICU discharge, hospital discharge, and 6 months post-discharge. QT and RF<sub>CSA</sub> changes from baseline were compared with each other and with change in motor function, physical ability, and physical health-related quality of life (HRQOL).</p><p><strong>Results: </strong>Two hundred thirty-seven images from 66 subjects were analyzed. RF<sub>CSA</sub> change was not significantly different from QT change at PICU (-8.07% [interquartile range (IQR), -17.11% to 4.80%] vs -4.55% [IQR, -14.32% to 4.35%]; <i>p</i> = 0.927) or hospital discharge (-5.62% [IQR, -15.00% to 9.42%] vs -8.81% [IQR, -18.67% to 2.39%]; <i>p</i> = 0.238) but was significantly greater than QT change at 6 months (32.7% [IQR, 5.74-109.76%] vs 9.66% [IQR, -8.17% to 25.70%]; <i>p</i> < 0.001). Motor function change at PICU discharge was significantly associated with RF<sub>CSA</sub> change (adjusted β coefficient, 0.02 [95% CI, 0.01-0.03]; <i>p</i> = 0.013) but not QT change (adjusted β coefficient, -0.01 [95% CI, -0.02 to 0.01]; <i>p</i> = 0.415). Similar results were observed for physical HRQOL changes at hospital discharge (adjusted β coefficient for RF<sub>CSA</sub> change, 0.51 [95% CI, 0.10-0.92]; <i>p</i> = 0.017 and adjusted β coefficient for QT change, -0.21 [-0.76 to 0.35]; <i>p</i> = 0.458). Physical ability was not significantly associated with RFCSA or QT changes at 6 months post-discharge.</p><p><strong>Conclusions and relevance: </strong>Ultrasound derived RF<sub>CSA</sub> is associated with PICU motor function and hospital discharge physical HRQOL changes, unlike QT, and may be more useful for in-hospital muscle monitoring in critically ill children.</p>\",\"PeriodicalId\":10759,\"journal\":{\"name\":\"Critical Care Explorations\",\"volume\":\"5 6\",\"pages\":\"e0937\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/09/cc9-5-e0937.PMC10281326.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Critical Care Explorations\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/CCE.0000000000000937\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care Explorations","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/CCE.0000000000000937","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Muscle Ultrasound Changes and Physical Function of Critically Ill Children: A Comparison of Rectus Femoris Cross-Sectional Area and Quadriceps Thickness Measurements.
Quadriceps thickness (QT) and rectus femoris cross-sectional area (RFCSA) are both used to evaluate muscle changes in critically ill children. However, their correlation and association with physical function has not been compared.
Objectives: To compare QT with RFCSA changes, and their association with physical function in critically ill children.
Design setting and participants: Secondary analysis of a prospective cohort study of children 0-18 years old admitted to a tertiary mixed PICU between January 2015 and October 2018 with PICU stay greater than 48 hours and greater than or equal to one organ dysfunction.
Main outcomes and measures: Ultrasound QT and RFCSA were measured at PICU admission, PICU discharge, hospital discharge, and 6 months post-discharge. QT and RFCSA changes from baseline were compared with each other and with change in motor function, physical ability, and physical health-related quality of life (HRQOL).
Results: Two hundred thirty-seven images from 66 subjects were analyzed. RFCSA change was not significantly different from QT change at PICU (-8.07% [interquartile range (IQR), -17.11% to 4.80%] vs -4.55% [IQR, -14.32% to 4.35%]; p = 0.927) or hospital discharge (-5.62% [IQR, -15.00% to 9.42%] vs -8.81% [IQR, -18.67% to 2.39%]; p = 0.238) but was significantly greater than QT change at 6 months (32.7% [IQR, 5.74-109.76%] vs 9.66% [IQR, -8.17% to 25.70%]; p < 0.001). Motor function change at PICU discharge was significantly associated with RFCSA change (adjusted β coefficient, 0.02 [95% CI, 0.01-0.03]; p = 0.013) but not QT change (adjusted β coefficient, -0.01 [95% CI, -0.02 to 0.01]; p = 0.415). Similar results were observed for physical HRQOL changes at hospital discharge (adjusted β coefficient for RFCSA change, 0.51 [95% CI, 0.10-0.92]; p = 0.017 and adjusted β coefficient for QT change, -0.21 [-0.76 to 0.35]; p = 0.458). Physical ability was not significantly associated with RFCSA or QT changes at 6 months post-discharge.
Conclusions and relevance: Ultrasound derived RFCSA is associated with PICU motor function and hospital discharge physical HRQOL changes, unlike QT, and may be more useful for in-hospital muscle monitoring in critically ill children.
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