Muscle ultrasound changes and physical function of critically ill children: a comparison of rectus femoris cross-sectional area and quadriceps thickness measurements
IMPORTANCE: Quadriceps thickness (QT) and rectus femoris cross-sectional area (RFCSA) are both used to evaluate muscle changes in critically ill children. However, their correlation and association with physical function has not been compared. OBJECTIVES: To compare QT with RFCSAchanges, and their a...
| Main Authors: | , , , |
|---|---|
| Other Authors: | |
| Format: | Journal Article |
| Language: | English |
| Published: |
2024
|
| Subjects: | |
| Online Access: | https://hdl.handle.net/10356/173558 |
| _version_ | 1824453548951207936 |
|---|---|
| author | Ong, Chengsi Lee, Jan Hau Leow, Melvin Khee-Shing Puthucheary, Zudin A. |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Ong, Chengsi Lee, Jan Hau Leow, Melvin Khee-Shing Puthucheary, Zudin A. |
| author_sort | Ong, Chengsi |
| collection | NTU |
| description | IMPORTANCE: Quadriceps thickness (QT) and rectus femoris cross-sectional area (RFCSA) are both used to evaluate muscle changes in critically ill children. However, their correlation and association with physical function has not been compared. OBJECTIVES: To compare QT with RFCSAchanges, and their association with physical function in critically ill children. DESIGN, SETTING, AND PARTICIPANTS: Secondary analysis of a prospective cohort study of children 0-18 years old admitted to a tertiary mixed PICU between January 2015 and October 2018 with PICU stay greater than 48 hours and greater than or equal to one organ dysfunction. MAIN OUTCOMES AND MEASURES: Ultrasound QT and RFCSAwere measured at PICU admission, PICU discharge, hospital discharge, and 6 months post-discharge. QT and RFCSAchanges from baseline were compared with each other and with change in motor function, physical ability, and physical health-related quality of life (HRQOL). RESULTS: Two hundred thirty-seven images from 66 subjects were analyzed. RFCSAchange was not significantly different from QT change at PICU (-8.07% [interquartile range (IQR),-17.11% to 4.80%] vs-4.55% [IQR,-14.32% to 4.35%]; p = 0.927) or hospital discharge (-5.62% [IQR,-15.00% to 9.42%] vs-8.81% [IQR,-18.67% to 2.39%]; p = 0.238) but was significantly greater than QT change at 6 months (32.7% [IQR, 5.74-109.76%] vs 9.66% [IQR,-8.17% to 25.70%]; p < 0.001). Motor function change at PICU discharge was significantly associated with RFCSAchange (adjusted β coefficient, 0.02 [95% CI, 0.01-0.03]; p = 0.013) but not QT change (adjusted β coefficient,-0.01 [95% CI,-0.02 to 0.01]; p = 0.415). Similar results were observed for physical HRQOL changes at hospital discharge (adjusted β coefficient for RFCSAchange, 0.51 [95% CI, 0.10-0.92]; p = 0.017 and adjusted β coefficient for QT change,-0.21 [-0.76 to 0.35]; p = 0.458). Physical ability was not significantly associated with RFCSA or QT changes at 6 months post-discharge. CONCLUSIONS AND RELEVANCE: Ultrasound derived RFCSAis associated with PICU motor function and hospital discharge physical HRQOL changes, unlike QT, and may be more useful for in-hospital muscle monitoring in critically ill children. |
| first_indexed | 2025-02-19T03:08:11Z |
| format | Journal Article |
| id | ntu-10356/173558 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2025-02-19T03:08:11Z |
| publishDate | 2024 |
| record_format | dspace |
| spelling | ntu-10356/1735582024-02-18T15:38:13Z Muscle ultrasound changes and physical function of critically ill children: a comparison of rectus femoris cross-sectional area and quadriceps thickness measurements Ong, Chengsi Lee, Jan Hau Leow, Melvin Khee-Shing Puthucheary, Zudin A. Lee Kong Chian School of Medicine (LKCMedicine) Duke-NUS Medical School Clinical Nutrition Research Center, A*STAR Tan Tock Seng Hospital Medicine, Health and Life Sciences Critically Ill Children Quadriceps IMPORTANCE: Quadriceps thickness (QT) and rectus femoris cross-sectional area (RFCSA) are both used to evaluate muscle changes in critically ill children. However, their correlation and association with physical function has not been compared. OBJECTIVES: To compare QT with RFCSAchanges, and their association with physical function in critically ill children. DESIGN, SETTING, AND PARTICIPANTS: Secondary analysis of a prospective cohort study of children 0-18 years old admitted to a tertiary mixed PICU between January 2015 and October 2018 with PICU stay greater than 48 hours and greater than or equal to one organ dysfunction. MAIN OUTCOMES AND MEASURES: Ultrasound QT and RFCSAwere measured at PICU admission, PICU discharge, hospital discharge, and 6 months post-discharge. QT and RFCSAchanges from baseline were compared with each other and with change in motor function, physical ability, and physical health-related quality of life (HRQOL). RESULTS: Two hundred thirty-seven images from 66 subjects were analyzed. RFCSAchange was not significantly different from QT change at PICU (-8.07% [interquartile range (IQR),-17.11% to 4.80%] vs-4.55% [IQR,-14.32% to 4.35%]; p = 0.927) or hospital discharge (-5.62% [IQR,-15.00% to 9.42%] vs-8.81% [IQR,-18.67% to 2.39%]; p = 0.238) but was significantly greater than QT change at 6 months (32.7% [IQR, 5.74-109.76%] vs 9.66% [IQR,-8.17% to 25.70%]; p < 0.001). Motor function change at PICU discharge was significantly associated with RFCSAchange (adjusted β coefficient, 0.02 [95% CI, 0.01-0.03]; p = 0.013) but not QT change (adjusted β coefficient,-0.01 [95% CI,-0.02 to 0.01]; p = 0.415). Similar results were observed for physical HRQOL changes at hospital discharge (adjusted β coefficient for RFCSAchange, 0.51 [95% CI, 0.10-0.92]; p = 0.017 and adjusted β coefficient for QT change,-0.21 [-0.76 to 0.35]; p = 0.458). Physical ability was not significantly associated with RFCSA or QT changes at 6 months post-discharge. CONCLUSIONS AND RELEVANCE: Ultrasound derived RFCSAis associated with PICU motor function and hospital discharge physical HRQOL changes, unlike QT, and may be more useful for in-hospital muscle monitoring in critically ill children. Published version This study was supported by a grant from the KK Women’s and Children’s Hospital Health Endowment Fund (KKHHEF/2014/05). 2024-02-14T02:17:27Z 2024-02-14T02:17:27Z 2023 Journal Article Ong, C., Lee, J. H., Leow, M. K. & Puthucheary, Z. A. (2023). Muscle ultrasound changes and physical function of critically ill children: a comparison of rectus femoris cross-sectional area and quadriceps thickness measurements. Critical Care Explorations, 5(6), e0937-. https://dx.doi.org/10.1097/CCE.0000000000000937 2639-8028 https://hdl.handle.net/10356/173558 10.1097/CCE.0000000000000937 37346230 2-s2.0-85163386533 6 5 e0937 en KKHHEF/2014/05 Critical Care Explorations © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBYNC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. application/pdf |
| spellingShingle | Medicine, Health and Life Sciences Critically Ill Children Quadriceps Ong, Chengsi Lee, Jan Hau Leow, Melvin Khee-Shing Puthucheary, Zudin A. Muscle ultrasound changes and physical function of critically ill children: a comparison of rectus femoris cross-sectional area and quadriceps thickness measurements |
| title | Muscle ultrasound changes and physical function of critically ill children: a comparison of rectus femoris cross-sectional area and quadriceps thickness measurements |
| title_full | Muscle ultrasound changes and physical function of critically ill children: a comparison of rectus femoris cross-sectional area and quadriceps thickness measurements |
| title_fullStr | Muscle ultrasound changes and physical function of critically ill children: a comparison of rectus femoris cross-sectional area and quadriceps thickness measurements |
| title_full_unstemmed | Muscle ultrasound changes and physical function of critically ill children: a comparison of rectus femoris cross-sectional area and quadriceps thickness measurements |
| title_short | Muscle ultrasound changes and physical function of critically ill children: a comparison of rectus femoris cross-sectional area and quadriceps thickness measurements |
| title_sort | muscle ultrasound changes and physical function of critically ill children a comparison of rectus femoris cross sectional area and quadriceps thickness measurements |
| topic | Medicine, Health and Life Sciences Critically Ill Children Quadriceps |
| url | https://hdl.handle.net/10356/173558 |
| work_keys_str_mv | AT ongchengsi muscleultrasoundchangesandphysicalfunctionofcriticallyillchildrenacomparisonofrectusfemoriscrosssectionalareaandquadricepsthicknessmeasurements AT leejanhau muscleultrasoundchangesandphysicalfunctionofcriticallyillchildrenacomparisonofrectusfemoriscrosssectionalareaandquadricepsthicknessmeasurements AT leowmelvinkheeshing muscleultrasoundchangesandphysicalfunctionofcriticallyillchildrenacomparisonofrectusfemoriscrosssectionalareaandquadricepsthicknessmeasurements AT puthuchearyzudina muscleultrasoundchangesandphysicalfunctionofcriticallyillchildrenacomparisonofrectusfemoriscrosssectionalareaandquadricepsthicknessmeasurements |