PDF(Pubmed)
Abstract：
In critical care settings, ultrasound (US) of the quadriceps muscle and Bioelectrical Impedance Analysis (BIA) are noninvasive and widely available tools to evaluate muscle mass. We studied whether baseline muscle mass affects physical function in intensive care unit (ICU) survivors after discharge. This retrospective review of a prospective cohort enrolled 30 patients admitted to the medical ICU between April 2016 and June 2018. On ICU admission, quadriceps muscle thickness and skeletal muscle mass were measured using US and BIA, respectively. Muscle strength and physical function were measured using handgrip dynamometry, the 6-min walk test, and the Barthel index questionnaire survey during every clinic visit at 1, 3, 6, and 12 months after hospital discharge. Skeletal muscle mass at ICU admission was statistically correlated with the 6-min walk distance (6MWD) and Barthel index score. The segmental lean mass of the right arm was also positively correlated with handgrip muscle strength at 6 months after discharge. Likewise, the correlation between quadriceps muscle thickness at ICU admission and 6MWD at 6 months after discharge was positive and statistically significant. Multivariate regression analysis showed that skeletal muscle mass was associated with a reduced 6MWD, but the length of ICU stay was not. The segmental lean mass of the right arm also showed a significant association with handgrip strength after discharge. Low muscle mass on ICU admission is associated with reduced muscle strength, causing impaired physical function after hospital discharge in ICU survivors.
摘要：
在重症监护环境中，股四头肌的超声（US）和生物电阻抗分析（BIA）是评估肌肉质量的非侵入性和广泛可用的工具。我们研究了出院后重症监护病房（ICU）幸存者的基线肌肉质量是否会影响身体功能。这项前瞻性队列的回顾性研究纳入了2016年4月至2018年6月期间入住内科ICU的30名患者。入住ICU时，使用US和BIA测量股四头肌厚度和骨骼肌质量，分别。使用手握测力计测量肌肉力量和身体功能，6分钟步行测试，出院后1、3、6和12个月，每次就诊时进行Barthel指数问卷调查。入住ICU时的骨骼肌质量与6分钟步行距离（6MWD）和Barthel指数评分具有统计学相关性。出院后6个月，右臂的节段性瘦体重也与握力肌力呈正相关。同样，入住ICU时股四头肌厚度与出院后6个月6MWD呈正相关,具有统计学意义.多因素回归分析显示骨骼肌质量降低与6MWD,但ICU的停留时间不是。出院后，右臂的节段性瘦体重也与握力显着相关。入住ICU时肌肉质量低与肌肉力量降低有关，导致ICU幸存者出院后身体功能受损。
