The use of ultrasound in the evaluation of lean body mass and the forethought of clinical outcomes in critical patients

• Autor(a) principal: Sodré, Yone Gabrielle do Nascimento
• Data de Publicação: 2024
• Outros Autores: Alves Rodrigues, Polyana
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista JRG de Estudos Acadêmicos
• Texto Completo: http://revistajrg.com/index.php/jrg/article/view/907
• topic: Atrofia Muscular; Músculo Quadríceps; Ultrassonografia; Unidades de Terapia Intensiva; Intensive Care Units; Muscular Atrophy; Quadriceps Muscle; Ultrasonography

Muscle loss in critically ill patients is common due to prolonged immobilization, inflammatory state, severity of the underlying disease, metabolic complications and difficulty in adequate intake of essential nutrients. In these patients, monitoring nutritional status is essential, but challenging due to practical limitations in intensive care environments. In this context, ultrasound has emerged as a promising bedside tool for muscle mass assessment. This integrative literature review aims to answer the following question: do reductions in muscle quality and quantity have implications for clinical outcomes in critically ill patients? The search for scientific articles was conducted through an electronic search on the PubMed portal, with inclusion criteria that included full articles available electronically, published in Portuguese, English, or Spanish, addressing muscle quality/quantity (evaluated by ultrasound) and clinical outcomes in adult critical patients (age > 18 years). Studies focused on the pectoral and diaphragm muscles, research with non-critical patients, review articles and presentation letters were excluded from the sample. Fifteen studies, totaling 992 patients, met the selection criteria. The reductions observed during the hospitalization period were significant and progressive, establishing a consistent correlation with clinical and functional outcomes in most studies. The increase in echogenicity and reductions in thickness and muscle area appear to be related to increased mortality, mechanical ventilation time, hospitalization time, organ dysfunction and worsening functional capacity. This set of evidence highlights the importance of muscle assessment and ultrasound as a valuable tool to understand and anticipate clinical developments in critically ill patients.