The use of muscle ultrasound to detect critical illness myopathy in patients with sepsis: an observational cohort study

Abstract Background Critical illness myopathy (CIM) has negative impact on patient outcomes. We aimed to explore the diagnostic value of bedside ultrasonography for early identification of CIM in septic patients and its correlation with other diagnostic methods. This prospective observational study...

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Main Authors: Mostafa M. Elkholy, Mohammed A. Osman, Ahmed S. Abd El Basset, Sameh K. El Maraghi, Hamdy M. Saber
Format: Article
Language:English
Published: SpringerOpen 2024-02-01
Series:The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Subjects:
Online Access:https://doi.org/10.1186/s41983-024-00808-w
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author Mostafa M. Elkholy
Mohammed A. Osman
Ahmed S. Abd El Basset
Sameh K. El Maraghi
Hamdy M. Saber
author_facet Mostafa M. Elkholy
Mohammed A. Osman
Ahmed S. Abd El Basset
Sameh K. El Maraghi
Hamdy M. Saber
author_sort Mostafa M. Elkholy
collection DOAJ
description Abstract Background Critical illness myopathy (CIM) has negative impact on patient outcomes. We aimed to explore the diagnostic value of bedside ultrasonography for early identification of CIM in septic patients and its correlation with other diagnostic methods. This prospective observational study included 40 ICU patients diagnosed with sepsis on admission or within 48 h later according to the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). They were evaluated using muscle ultrasound, electrodiagnostic and clinical muscle assessment (Medical Research Council, MRC) at two time points, the first was between days 2 and 5 and the second was between days 10 and 15. Results There was significant deterioration of neuromuscular function between the two evaluation points demonstrated by decline in MRC, abnormal nerve conduction and electromyography (EMG) and increased muscle echogenicity on ultrasonography (P ≤ 0.001). Sepsis-Related Organ Failure Assessment (SOFA) score significantly correlated with different neuromuscular assessment tools. MRC had significant correlation with myopathic EMG (P ≤ 0.001, r = − 0.869) and increased muscle echogenicity (P ≤ 0.001, r = − 0.715). Abnormal ultrasonographic muscle architecture had sensitivity of 100%, specificity of 75% and positive likelihood ratio of 4 in detecting muscle dysfunction compared to myopathic EMG. Conclusions Bedside peripheral muscle ultrasound echogenicity grade could be used as an additional screening test in ICU septic patients for early detection of CIM.
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spelling doaj.art-99d755f53b994c4cb8ba129fc10848b02024-03-05T18:01:54ZengSpringerOpenThe Egyptian Journal of Neurology, Psychiatry and Neurosurgery1687-83292024-02-016011810.1186/s41983-024-00808-wThe use of muscle ultrasound to detect critical illness myopathy in patients with sepsis: an observational cohort studyMostafa M. Elkholy0Mohammed A. Osman1Ahmed S. Abd El Basset2Sameh K. El Maraghi3Hamdy M. Saber4Department of Clinical Neurophysiology (Neuro-Diagnostic and Research Center), Faculty of Medicine, Beni-Suef UniversityDepartment of Critical Care Medicine, Arish General Hospital, Ministry of HealthDepartment of Radiology, Faculty of Medicine, Beni-Suef UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Beni-Suef UniversityDepartment of Critical Care Medicine, Faculty of Medicine, Beni-Suef UniversityAbstract Background Critical illness myopathy (CIM) has negative impact on patient outcomes. We aimed to explore the diagnostic value of bedside ultrasonography for early identification of CIM in septic patients and its correlation with other diagnostic methods. This prospective observational study included 40 ICU patients diagnosed with sepsis on admission or within 48 h later according to the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). They were evaluated using muscle ultrasound, electrodiagnostic and clinical muscle assessment (Medical Research Council, MRC) at two time points, the first was between days 2 and 5 and the second was between days 10 and 15. Results There was significant deterioration of neuromuscular function between the two evaluation points demonstrated by decline in MRC, abnormal nerve conduction and electromyography (EMG) and increased muscle echogenicity on ultrasonography (P ≤ 0.001). Sepsis-Related Organ Failure Assessment (SOFA) score significantly correlated with different neuromuscular assessment tools. MRC had significant correlation with myopathic EMG (P ≤ 0.001, r = − 0.869) and increased muscle echogenicity (P ≤ 0.001, r = − 0.715). Abnormal ultrasonographic muscle architecture had sensitivity of 100%, specificity of 75% and positive likelihood ratio of 4 in detecting muscle dysfunction compared to myopathic EMG. Conclusions Bedside peripheral muscle ultrasound echogenicity grade could be used as an additional screening test in ICU septic patients for early detection of CIM.https://doi.org/10.1186/s41983-024-00808-wCritical illness myopathyICU-acquired weaknessMuscle ultrasoundMuscle echogenicitySepsis
spellingShingle Mostafa M. Elkholy
Mohammed A. Osman
Ahmed S. Abd El Basset
Sameh K. El Maraghi
Hamdy M. Saber
The use of muscle ultrasound to detect critical illness myopathy in patients with sepsis: an observational cohort study
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery
Critical illness myopathy
ICU-acquired weakness
Muscle ultrasound
Muscle echogenicity
Sepsis
title The use of muscle ultrasound to detect critical illness myopathy in patients with sepsis: an observational cohort study
title_full The use of muscle ultrasound to detect critical illness myopathy in patients with sepsis: an observational cohort study
title_fullStr The use of muscle ultrasound to detect critical illness myopathy in patients with sepsis: an observational cohort study
title_full_unstemmed The use of muscle ultrasound to detect critical illness myopathy in patients with sepsis: an observational cohort study
title_short The use of muscle ultrasound to detect critical illness myopathy in patients with sepsis: an observational cohort study
title_sort use of muscle ultrasound to detect critical illness myopathy in patients with sepsis an observational cohort study
topic Critical illness myopathy
ICU-acquired weakness
Muscle ultrasound
Muscle echogenicity
Sepsis
url https://doi.org/10.1186/s41983-024-00808-w
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