徳島大学 教育・研究者情報データベース(EDB)

1. 徳島大学

1. 中西 信人

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2. 堤 理恵

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3. (英) Okayama Yoshihiro

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4. 髙島 拓也([徳島大学.大学院医歯薬学研究部.医学域.先端医学教育研究プロジェクト]/[徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.救急集中治療医学])

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5. 上野 義豊([徳島大学.病院.先端医科医療開発研究プロジェクト]/[徳島大学.病院.診療科.救急科.救急集中治療科])

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6. 板垣 大雅

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7. (英) Tsutsumi Yasuo

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8. 阪上 浩([徳島大学.大学院医歯薬学研究部.医学域.栄養科学部門.医科栄養学系.代謝栄養学]/[徳島大学.糖尿病臨床・研究開発センター])

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9. (英) Oto Jun

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(英) Monitoring of muscle mass in criticaly ill patients: comparison of ultrasound and two bioelectrical impedance analysis devices

(英) Skeletal muscle atrophy commonly occurs in critically ill patients, and decreased muscle mass is associated with worse clinical outcomes. Muscle mass can be assessed using various tools, including ultrasound and bioelectrical impedance analysis (BIA). However, the effectiveness of muscle mass monitoring is unclear in critically ill patients. This study was conducted to compare ultrasound and BIA for the monitoring of muscle mass in critically ill patients. We recruited adult patients who were expected to undergo mechanical ventilation for > 48 h and to remain in the intensive care unit (ICU) for > 5 days. On days 1, 3, 5, 7, and 10, muscle mass was evaluated using an ultrasound and two BIA devices (Bioscan: Malton International, England; Physion: Nippon Shooter, Japan). The influence of fluid balance was also evaluated between each measurement day. We analyzed 93 images in 21 patients. The age of the patients was 69 (interquartile range, IQR, 59-74) years, with 16 men and 5 women. The length of ICU stay was 11 days (IQR, 9-25 days). The muscle mass, monitored by ultrasound, decreased progressively by 9.2% (95% confidence interval (CI), 5.9-12.5%), 12.7% (95% CI, 9.3-16.1%), 18.2% (95% CI, 14.7-21.6%), and 21.8% (95% CI, 17.9-25.7%) on days 3, 5, 7, and 10 ( < 0.01), respectively, with no influence of fluid balance ( = 0.04, = 0.74). The muscle mass did not decrease significantly in both the BIA devices (Bioscan, = 0.14; Physion, = 0.60), and an influence of fluid balance was observed (Bioscan, = 0.37, < 0.01; Physion, = 0.51, < 0.01). The muscle mass assessment at one point between ultrasound and BIA was moderately correlated (Bioscan, = 0.51, < 0.01; Physion, = 0.37, < 0.01), but the change of muscle mass in the same patient did not correlate between these two devices (Bioscan, = - 0.05, = 0.69; Physion, = 0.23, = 0.07). Ultrasound is suitable for sequential monitoring of muscle atrophy in critically ill patients. Monitoring by BIA should be carefully interpreted owing to the influence of fluid change. UMIN000031316. Retrospectively registered on 15 February 2018.

1. 超音波(ultrasound)
2. (英) Bioelectrical impedance analysis
3. 筋萎縮(muscle atrophy)

1. (英) Article.ELocationID: 10.1186/s40560-019-0416-y

2. (英) Article.PublicationTypeList.PublicationType: Journal Article

3. (英) KeywordList.Keyword: Bioelectrical impedance analysis

4. (英) KeywordList.Keyword: Critically ill patients

5. (英) KeywordList.Keyword: Fluid balance

6. (英) KeywordList.Keyword: Muscle mass

7. (英) KeywordList.Keyword: Ultrasound

8. (英) CoiStatement: Competing interestsThe authors declare that they have no competing interests.