Comparison of ultrasound-derived muscle thickness with computed tomography muscle cross-sectional area on admission to the intensive care unit : A pilot cross-sectional study

Journal article


Lambell, Kate J., Tierney, Audrey C., Wang, Jessica C., Nanjayya, Vinodh, Forsyth, Adrienne, Goh, Gerard S., Vicendese, Don, Ridley, Emma J., Parry, Selina M., Mourtzakis, Marina and King, Susannah J.. (2021). Comparison of ultrasound-derived muscle thickness with computed tomography muscle cross-sectional area on admission to the intensive care unit : A pilot cross-sectional study. Journal of Parenteral and Enteral Nutrition. 45(1), pp. 136-145. https://doi.org/10.1002/jpen.1822
AuthorsLambell, Kate J., Tierney, Audrey C., Wang, Jessica C., Nanjayya, Vinodh, Forsyth, Adrienne, Goh, Gerard S., Vicendese, Don, Ridley, Emma J., Parry, Selina M., Mourtzakis, Marina and King, Susannah J.
Abstract

Introduction
The development of bedside methods to assess muscularity is an essential critical care nutrition research priority. We aimed to compare ultrasound-derived muscle thickness at 5 landmarks with computed tomography (CT) muscle area at intensive care unit (ICU) admission. Secondary aims were to (1) combine muscle thicknesses and baseline covariates to evaluate correlation with CT muscle area and (2) assess the ability of the best-performing ultrasound model to identify patients with low CT muscle area.

Methods
Adult patients who underwent CT scanning at the third lumbar area <72 hours after ICU admission were prospectively recruited. Muscle thickness was measured at mid-upper arm, forearm, abdomen, and thighs. Low CT muscle area was determined using published cutoffs. Pearson correlation compared ultrasound-derived muscle thickness and CT muscle area. Linear regression was used to develop ultrasound prediction models. Bland-Altman analyses compared ultrasound-predicted and CT-measured muscle area.

Results
Fifty ICU patients were enrolled, aged 52 ± 20 years. Ultrasound-derived muscle thickness at each landmark correlated with CT muscle area (P < .001). The sum of muscle thickness at mid-upper arm and bilateral thighs, including age, sex, and the Charlson Comorbidity Index, improved the correlation with CT muscle area (r = 0.85; P < .001). Mean difference between ultrasound-predicted and CT-measured muscle area was −2 cm2 (95% limits of agreement, −40 cm2 to +36 cm2). The best-performing ultrasound model demonstrated good ability to identify 14 patients with low CT muscle area (area under curve = 0.79).

Conclusion
Ultrasound shows potential for assessing muscularity at ICU admission (Clinicaltrials.gov NCT03019913).

Keywordsbody composition; computed tomography; critical illness; intensive care unit; skeletal muscle mass; ultrasound
Year2021
JournalJournal of Parenteral and Enteral Nutrition
Journal citation45 (1), pp. 136-145
PublisherJohn Wiley & Sons Ltd
ISSN0148-6071
Digital Object Identifier (DOI)https://doi.org/10.1002/jpen.1822
Open accessPublished as green open access
Page range136-145
FunderResearch Training Program Scholarship (RTP), Australian Government
Author's accepted manuscript
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All rights reserved
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Open
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online15 Apr 2020
Publication process dates
Accepted25 Feb 2020
Deposited21 Nov 2022
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