[O-RS-02-2] Change in muscle cross-sectional area and its influence on functional outcome in ventilated intensive care unit patients：A prospective study.
Keywords:intensive care unit, skeletal muscle, prolonged bed rest
【Purpose】
This study aimed to identify changes in muscle mass, and its relationship with functional outcome in intensive care unit（ICU）patients ventilated for ≥ 2days.
【Methods】
This study was a prospective study. The cross-sectional area（CSA）of the multifidus muscle was assessed and measured using computed tomography（CT）in ICU patients on admission and at discharge and in age-matched healthy controls. The physical functional test for the ICU（PFIT-s）, Medical Research Council（MRC）sum score, and duration of prolonged bed-rest were assessed in the ICU patients on admission and at discharge. Paired t-test was used to assess changes in outcomes, and unpaired t-test was used to compare the results between the ICU patients and controls. Pearson's correlation coefficient was used to assess the relationship between muscle CSA and functional outcome. The study was approved by the regional ethics committee and conducted in accordance with the Declaration of Helsinki.
【Results】
Nine ICU patients and nine age-matched healthy controls were recruited for the study. The baseline characteristics of muscle CSA were not significantly different between the ICU patients on admission and controls. However, muscle CSA was significantly reduced in the ICU patients at discharge compared with that in the ICU patients on admission and in the controls（P＜0.05）. At discharge from the ICU, PFIT-s and MRC were not significantly reduced. The decrease muscle CSA in the ICU patients was found to be significantly correlated with the duration of prolonged bed-rest and MRC（P＜0.05）.
【Discussion】
In the present study, the decrease in muscle CSA, and its correlation with prolonged bed-rest, and MRC suggest that interventions to prevent muscle loss in ICU patients ventilated for ≥ 2 days are inadequate. Therefore, primary physical therapy intervention should be the focus for preventing muscle loss in these patients.
This study aimed to identify changes in muscle mass, and its relationship with functional outcome in intensive care unit（ICU）patients ventilated for ≥ 2days.
【Methods】
This study was a prospective study. The cross-sectional area（CSA）of the multifidus muscle was assessed and measured using computed tomography（CT）in ICU patients on admission and at discharge and in age-matched healthy controls. The physical functional test for the ICU（PFIT-s）, Medical Research Council（MRC）sum score, and duration of prolonged bed-rest were assessed in the ICU patients on admission and at discharge. Paired t-test was used to assess changes in outcomes, and unpaired t-test was used to compare the results between the ICU patients and controls. Pearson's correlation coefficient was used to assess the relationship between muscle CSA and functional outcome. The study was approved by the regional ethics committee and conducted in accordance with the Declaration of Helsinki.
【Results】
Nine ICU patients and nine age-matched healthy controls were recruited for the study. The baseline characteristics of muscle CSA were not significantly different between the ICU patients on admission and controls. However, muscle CSA was significantly reduced in the ICU patients at discharge compared with that in the ICU patients on admission and in the controls（P＜0.05）. At discharge from the ICU, PFIT-s and MRC were not significantly reduced. The decrease muscle CSA in the ICU patients was found to be significantly correlated with the duration of prolonged bed-rest and MRC（P＜0.05）.
【Discussion】
In the present study, the decrease in muscle CSA, and its correlation with prolonged bed-rest, and MRC suggest that interventions to prevent muscle loss in ICU patients ventilated for ≥ 2 days are inadequate. Therefore, primary physical therapy intervention should be the focus for preventing muscle loss in these patients.