Evaluation study of sequential ultrasound measurement of limb skeletal muscle and diaphragm thickness in elderly septic mechanically ventilated patients
10.3760/cma.j.issn.0254-9026.2025.06.015
- VernacularTitle:序贯超声测量肢体骨骼肌及膈肌厚度对老年脓毒症机械通气患者的评价研究
- Author:
Qili ZHANG
1
;
Hong SUN
1
;
Qian ZHOU
1
;
Qian SONG
1
;
Ruijun GUO
1
;
Shuo LI
1
Author Information
1. 首都医科大学附属北京朝阳医院超声医学科，北京 100020
- Publication Type:Journal Article
- Keywords:
Ultrasound;
Skeletal muscle;
Diaphragm;
Elderly;
Sepsis
- From:
Chinese Journal of Geriatrics
2025;44(6):761-765
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of sequential ultrasound in assessing skeletal muscle and diaphragm thickness in elderly septic patients.Methods:A retrospective study was conducted.Fifty-one elderly patients with sepsis who underwent ultrasound examinations at Beijing Chaoyang Hospital from August 2021 to August 2023 were selected, including 30 males and 21 females.Ultrasound technology was used to measure the thickness of limb skeletal muscles(biceps brachii, flexor carpi radialis, quadriceps femoris, and tibialis anterior)and diaphragm, and sequential monitoring was performed at different time points(admission, the 3rd day after admission, and the 7th day after admission)to analyze the variation rules of their thickness.The correlations between the changes in muscle thickness and the severity of the disease[such as the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores and the Sepsis Organ Failure Assessment(SOFA)scores], mechanical ventilation time, and length of hospital stay were analyzed.Results:Compared with those at admission, the thickness of limb skeletal muscles and diaphragm in elderly septic patients with mechanical ventilation significantly decreased with the prolongation of hospital stay( P<0.05).The degree of thickness reduction in the flexor carpi radialis and rectus femoris was positively correlated with the APACHE II score.The degree of thickness reduction in the biceps brachii was positively correlated with the SOFA score.The degree of thickness reduction in the flexor carpi radialis, rectus femoris, and diaphragm was positively correlated with both mechanical ventilation time and hospital stay( P<0.05).Correlation heatmap analysis showed that the thickness of the flexor carpi radialis was significantly correlated with hospital stay days and APACHE II score(correlation coefficients were 100.20 and 67.47, respectively), indicating that the longer the hospital stay and the more severe the condition, the more serious the atrophy of the flexor carpi radialis. Conclusions:Measuring the thickness of skeletal muscles and the diaphragm in elderly sepsis patients using ultrasound serves as an efficient and non-invasive method for assessing the disease state, predicting prognosis, and guiding clinical treatment decisions.This approach provides vital imaging-based evidence for refining diagnostic and therapeutic strategies for elderly sepsis patients, thereby promising to enhance clinical outcomes and the quality of rehabilitation for these individuals.
