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The Magnitude and Time Course of Muscle Cross-section Decrease in Intensive Care Unit Patients
Dianne Ten Haaf1, Bea Hemmen, Henk van de Meent
1From the Adelante Rehabilitation Centre, Hoensbroek, The Netherlands (DtH, BH); Department of Rehabilitation Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands (BH); Department of Rehabilitation Medicine, Maastricht University, School of Public Health and Primary Care, Maastricht, The Netherlands (BH); Department of Rehabilitation Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands (DtH, HvdM); and Department of Human Movement Sciences, Maastricht University, Maastricht, The Netherlands (TJHB).
Immobilization in intensive care units causes significant muscle atrophy, particularly in the arms, within 2-4 weeks. This muscle cross-section decrease impacts critically ill patients and requires further investigation.
Area of Science:
- Critical Care Medicine
- Physiology
- Rehabilitation
Background:
- Immobilization and bedriddenness in intensive care units (ICUs) can lead to muscle atrophy.
- The precise impact of immobilization on ICU patients' muscle mass and quality of life is not fully understood.
Purpose of the Study:
- To quantify the rate and extent of muscle cross-section reduction in acutely critically ill patients.
- To examine the time course of muscle atrophy during intensive care unit stays.
Main Methods:
- An observational pilot study involving 34 intensive care unit patients.
- Bilateral ultrasound measurements of knee extensor and elbow flexor muscle cross-sections were collected.
- Data from 14 patients measured at least three times were analyzed.
Main Results:
- A statistically significant decrease in muscle cross-section over time was observed (P ≤ 0.001).
- Muscle cross-section reduction was significantly greater in the arms compared to the legs (P = 0.037).
- After four weeks, muscle atrophy had not yet plateaued.
Conclusions:
- Critically ill, bedridden intensive care unit patients experience significant muscle cross-section loss within 2 to 4 weeks.
- Arm muscles exhibit a more pronounced decrease in cross-section than leg muscles during intensive care unit stays.
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