Longitudinal Ultrasound Monitoring of Peripheral Muscle Loss in Neurocritical Patients.

Abstract

Ultrasound has become an important tool that offers clinical and practical benefits in the intensive care unit (ICU). Its real-time imaging provides immediate information to support prognostic evaluation and clinical decision-making. This study used ultrasound assessment to investigate the impact of hospitalization on muscle properties in neurocritical patients and analyze the relationship between peripheral muscle changes and motor sequelae. A total of 43 neurocritical patients admitted to the ICU were included. The inclusion criteria were patients with acute brain injuries with or without motor sequelae. Muscle ultrasonography assessments were performed during ICU admission and hospital discharge. Measurements included muscle thickness, cross-sectional area, and echogenicity of the biceps brachii, quadriceps femoris, and rectus femoris. Statistical analyses were used to compare muscle properties between time points (hospital admission vs. discharge) and between groups (patients with vs. without motor sequelae). Significance was set at 5%. Hospitalization had a significant effect on muscle thickness, cross-sectional area, and echogenicity in patients with and without motor sequelae (p < 0.05, effect sizes between 0.104 and 0.475). Patients with motor sequelae exhibited greater alterations in muscle echogenicity than those without (p < 0.05, effect sizes between 0.182 and 0.211). Changes in muscle thickness and cross-sectional area were similar between the groups (p > 0.05). Neurocritical patients experience significant muscle deterioration during hospitalization. Future studies should explore why echogenicity is more markedly affected than muscle thickness and cross-sectional area in patients with motor sequelae compared to those without.