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Bone ultrasound velocity in pediatric intensive care unit: a pilot study
Ayelet Zerem, Francis B Mimouni, Elie Picard1
1Pediatric Pulmonary Unit, Shaare Zedek Medical Center, affiliated to The Hebrew University School of Medicine and Pediatric department, Jerusalem 91031, Israel. Picard@szmc.org.il.
Insights
Pediatric intensive care unit (PICU) patients experience significant bone loss within the first three days of admission. This early bone weakening, measured by speed of sound (SOS), highlights the need for further research into preventive strategies.
Area of Science:
- Pediatric Intensive Care
- Bone Metabolism
- Medical Imaging
Background:
- Bone loss is a known complication for adult ICU patients.
- Children in pediatric intensive care units (PICUs) face risks like immobilization and poor nutrition, potentially leading to bone loss.
- Quantitative ultrasound (QUS) measures speed of sound (SOS) as a proxy for bone mineral density and strength.
Purpose of the Study:
- To evaluate early bone changes in children admitted to the PICU.
- To assess bone strength alterations during the initial days of intensive care.
Main Methods:
- A prospective, longitudinal, observational pilot study was conducted.
- Bone SOS was measured at the mid-shaft tibia in pediatric patients.
- Measurements were taken on the first day of hospitalization and again on days 2-3.
Main Results:
- Nineteen children participated in the study.
- Bone SOS significantly decreased within the first 3 days of PICU admission (p < 0.05).
- This represented approximately a 1% decrease in SOS over the initial 2-3 days.
Conclusions:
- Pediatric patients in intensive care show a significant reduction in bone strength after 3 days.
- Larger longitudinal studies are needed to understand the clinical implications.
- Further research may explore preventive interventions for bone loss in PICU patients.
Background:
Bone loss has been documented in adults in intensive care wards. Children admitted to pediatric intensive care units (PICU) are also exposed to many potential risk factors for bone loss such as immobilization, catabolic state, and nutritional depletion. Quantitative ultrasound technique that measures speed of sound (SOS) correlates with bone mineral density (BMD) and strength. Herein is a clinical prospective longitudinal, observational pilot study to evaluate early bone changes that occur during the first few days of PICU admission.
Methods:
Children are hospitalized in a pediatric intensive under general anesthesia and muscle paralysis. Bone SOS at the mid-shaft tibia was measured on the first day of hospitalization and on days 2 to 3 thereafter.
Results:
Nineteen children were studied. Bone SOS decreased during the first 3 days of hospitalization from 3,297 ± 315 to 3,260 ± 311 m/min (p < 0.05). The decrease was approximately 1% of the original SOS over the first 2 to 3 days of admission.
Conclusion:
There is a significant decrease in bone strength after 3 days in pediatric patients admitted to an intensive care department. Longitudinal studies of a larger group of children are necessary to determine the clinical meaning of the results and to possibly evaluate preventive approaches.
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