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Quantitative neuromuscular ultrasound in the intensive care unit

Authors

  • Michael S. Cartwright MD, MS,

    Corresponding author
    1. Department of Neurology, Wake Forest University School of Medicine, Reynolds Tower, Winston-Salem, North Carolina 27157, USA
    • Department of Neurology, Wake Forest University School of Medicine, Reynolds Tower, Winston-Salem, North Carolina 27157, USA
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  • Golda Kwayisi BS,

    1. Department of Neurology, Wake Forest University School of Medicine, Reynolds Tower, Winston-Salem, North Carolina 27157, USA
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  • Leah P. Griffin MS,

    1. Division of Public Health Sciences, Department of Biostatistics, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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  • Aarti Sarwal MD,

    1. Department of Neurology, Wake Forest University School of Medicine, Reynolds Tower, Winston-Salem, North Carolina 27157, USA
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  • Francis O. Walker MD,

    1. Department of Neurology, Wake Forest University School of Medicine, Reynolds Tower, Winston-Salem, North Carolina 27157, USA
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  • Jessica M. Harris AAS,

    1. Department of Neurology, Wake Forest University School of Medicine, Reynolds Tower, Winston-Salem, North Carolina 27157, USA
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  • Michael J. Berry PhD,

    1. Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
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  • Preet S. Chahal MD,

    1. Department of Neurology, Wake Forest University School of Medicine, Reynolds Tower, Winston-Salem, North Carolina 27157, USA
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  • Peter E. Morris MD

    1. Department of Pulmonary and Critical Care Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Abstract

Introduction: Intensive care unit acquired weakness (ICU-AW) results from a complex mixture of nerve and muscle pathology, and early identification is challenging. This pilot study was designed to examine the ultrasonographic changes that occur in muscles during ICU hospitalization. Methods: Patients admitted to the ICU for acute respiratory failure were enrolled prospectively and underwent serial muscle ultrasound for thickness and gray-scale assessment of the tibialis anterior, rectus femoris, abductor digiti minimi, biceps, and diaphragm muscles over 14 days. Results: Sixteen participants were enrolled. The tibialis anterior (P = 0.001) and rectus femoris (P = 0.041) had significant decreases in gray-scale standard deviation when analyzed over 14 days. No muscles showed significant changes in thickness. Conclusions: Ultrasound is an informative technique for assessing muscles of patients in the ICU, and lower extremity muscles demonstrated increased homogeneity during ICU stays. This technique should be examined further for diagnosing and tracking those with ICU-AW. Muscle Nerve, 2013

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