Relationship between ultrasonic changes of quadriceps femoris and acquired weakness of ICU in children
10.3969/j.issn.1001-1242.2025.01.006
- VernacularTitle:超声下股四头肌变化与儿童ICU获得性衰弱的关系
- Author:
Zhi LI
1
;
Jinggang WANG
1
;
Qingyun LI
1
Author Information
1. 深圳市儿童医院康复科,深圳市,518034
- Publication Type:Journal Article
- Keywords:
intensive care unit acquired weakness;
Medical Research Committee muscle strength score;
ultra-sonic evaluation
- From:
Chinese Journal of Rehabilitation Medicine
2025;40(1):32-37
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relationship between the changes of quadriceps femoris and ICU acquired weakness(ICU-AW)in children.Method:A prospective collection of pediatric patients treated in the intensive care unit of Shenzhen children's hospital from October 2022 to March 2023.The thickness and cross-sectional area of rectus femoris and the thickness of vastus intermedius were measured by ultrasound on the 1st,4th and 7th day after ICU.The first day served as the baseline to calculate the atrophy rate for each muscle.On the 7th day,the Medical Re-search committee muscle strength score(MRC score)and critical physical function test score(PFIT-s score)were performed.According to the MRC score＜48,patients were divided into ICU-AW group and non-ICU-AW group to analyze the relationship between ICU-AW and the changes of quadriceps femoris.Result:A total of 21 critically ill children were included,including 11 males and 10 females.The incidence of ICU-AW in children was 41.2％(4 cases were not evaluated because of delirium).Within 7 days after en-tering ICU,the atrophy rate of cross-sectional area of rectus femoris was the highest,reaching-8.00％±15.10％.Both groups showed the greatest rate of change in the vastus intermedius thickness over 7 days,with the ICU-AW group mainly showing an increase in thickness(19.51％±16.51％over 4 days,14.14％±28.13％over 7 days),while the non-ICU-AW group primarily showed atrophy(-16.07％±17.46％over 4 days,-15.55％±30.04％over 7 days).The ICU-AW group had an average increase in rectus femoris thickness of 4.51％±8.38％within 7 days of ICU admission,while the non-ICU-AW group had an average atrophy rate of-8.19％±11.79％.There was no correlation between muscular atrophy rate and PFIT-s score(all P＞0.05),but there was a moderate negative correlation between rectus femoris thickness atrophy rate and femoral intermediate muscle thickness atrophy rate and MRC score within 4 days,respectively(ritual color 0.541 million 0.657 million 0.004),and moderate negative correlation between MRC score and thickness atrophy rate of rectus femoris and vastus medius within 7 days.There was no significant correlation between the atrophy rate of cross-section-al area of rectus femoris and MRC score.Conclusion:Compared with the non-ICU-AW group,the muscle thickness in the ICU-AW group is mainly thickened rather than atrophied,which can be identified by ultrasound on the 4th day after ICU.The specific diagnostic threshold is worthy of further study.
