Role of ultrasound in diagnosis of icu acquired weakness

Michail, Hany Kamal; Youssef, Ibrahim Abbas; Ibrahim, Hanaa Osama

doi:10.21608/mjmr.2025.400956.2017

Role of ultrasound in diagnosis of icu acquired weakness

Articles in Press

Document Type : Original Article

Authors

¹ Anesthesiology and Intensive care, Minia University, Egypt

² Anesthesiology & Intensive care department, Faculty of Medicine, El-Minia University, Egypt.

10.21608/mjmr.2025.400956.2017

Abstract

Background: Skeletal muscle dysfunction frequently occurs in ICUs, resulting in muscular weakness and function loss.

Aim: To evaluate the effectiveness of ultrasound in detecting and monitoring ICU-acquired muscle weakness.

Patients and methods: This prospective cohort research involved 60 adult ICU cases, separated into two groups based on ICU-acquired weakness (ICU-AW): 39 with ICU-AW and 21 without. ICU-AW has been defined as a Medical Research Council score below 48.

Results: Significant variances have been observed among groups regarding the Medical Research Council (MRC) score, diagnosis, surgery, mechanical ventilation, sedative and analgesic use, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, vasopressor use, physical restraints, hypertension, diabetes, respiratory failure, and multiple organ dysfunction syndrome (MODS) (p-value under 0.05). Insignificant variances have been observed for peak glucose levels, glucocorticoid use, nutritional support, cardiac dysfunction, renal dysfunction, or liver dysfunction.

Among muscle parameters, the right rectus femoris percent change in cross-sectional area (ΔCSA) showed the highest diagnostic accuracy (84.5%), while the right biceps brachii percent change in cross-sectional area (ΔCSA) also demonstrated good performance (72%). The vastus intermedius percent change in muscle thickness (ΔTH) showed high sensitivity (greater than or equal to 79%) bilaterally with moderate accuracy.

Conclusion: Cases with ICU-acquired weakness were older, sicker, and had more complications. Muscle measurements helped diagnosis. Early detection is important to improve outcomes.

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