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Is sarcopenia a risk factor for reduced diaphragm function following hepatic resection? A study protocol for a
Gregory van der Kroft1, Sebastian Johannes Johannes Fritsch2, S S Rensen3,4
1Department of General, Hepatobiliary and Transplant Surgery, Uniklinik RWTH-Aachen, Aachen, Germany gregory.kroft@gmail.com.
BMJ Open
|November 17, 2021
Summary
Sarcopenia significantly impacts diaphragm function before and after liver surgery. This study investigates how muscle loss affects respiratory function in patients undergoing major hepatic resection, aiming to improve patient outcomes.
Area of Science:
- Investigates the intersection of sarcopenia, diaphragm function, and surgical outcomes in hepatobiliary surgery.
- Focuses on respiratory muscle physiology and its clinical implications in major abdominal interventions.
Background:
- Sarcopenia (age-related muscle loss) is linked to poorer pulmonary function and increased pneumonia risk.
- Liver surgery, particularly major hepatic resection, often compromises postoperative respiratory function.
- The impact of sarcopenia on diaphragm function and its response to liver surgery remains poorly understood.
Purpose of the Study:
- To compare diaphragm function in sarcopenic versus non-sarcopenic patients before major liver resection.
- To assess the impact of sarcopenia on the decline and recovery of diaphragm and respiratory muscle function post-liver surgery.
- To evaluate the relationship between preoperative diaphragm function and postoperative outcomes in sarcopenic patients.
Main Methods:
- Perioperative assessment of diaphragm function using ultrasound (B-mode, M-mode, speckle tracking) in 66 patients (33 sarcopenic, 33 non-sarcopenic) undergoing right-sided hemihepatectomy.
- Measurement of muscle mass (CT volumetry), muscle strength (handgrip), and physical performance (Short Physical Performance Battery).
- Analysis of rectus abdominis muscle biopsy for proteolytic and mitochondrial activity, inflammation, and redox status; serum biomarkers for systemic inflammation and sarcopenia.
Main Results:
- This trial is currently open for recruitment, with no results available yet.
- The study aims to provide novel insights into diaphragm function in the context of sarcopenia and major hepatic resection.
Conclusions:
- Anticipates that sarcopenic patients will exhibit reduced preoperative diaphragm function.
- Expects sarcopenic patients to experience a greater decline and slower recovery of respiratory muscle function post-surgery.
- Findings are expected to inform strategies for managing sarcopenia to mitigate pulmonary complications after liver surgery.
