在ICU住院期间,儿科患者肌肉缩的患病率
Jéssica K De Oliveira1,2,3, Taila C Piva4, Renata S Ferrari4
1Graduate Program in Pediatrics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil. jessicaknisspell@gmail.com.
European journal of pediatrics
|August 29, 2024
概括
重症儿童经历了显著的肌肉损失,特别是在机械通风的第二周. 超声监测显示,超过30%的患者肌肉缩,突出显示了其在儿科重症监护中的重要性.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 诊断成像诊断成像的使用
- 肌肉生理学 肌肉生理学
背景情况:
- 超声波 (美国) 是一种有价值的床边工具,用于监测危急患者的肌肉质量.
- 之前的研究证实了美国在成人肌肉缩检测的有效性,儿童数据有限.
研究的目的:
- 用超声波评估重症儿童的肌肉厚度和缩患病率.
- 在儿科重症监护室 (PICU) 住院期间评估双臂/双臂 (BB) 和四头骨 (QF) 肌肉变化.
主要方法:
- 在第三级医院的PICU进行前性纵向研究.
- 在通风儿童 (1个月-12岁) 中,对BB和QF厚度进行超声波测量,每24小时,每72小时,每周一次.
- 肌肉缩定义为>10%的厚度下降.
主要成果:
- 从第1周到第2周的BB厚度显著减少 (p=0.009) 和从24小时到第2周的QF (p=0.013).
- 肌肉缩的发病率在24小时至2周之间为59.3%.
- 在PICU住院2周后,缩患病率为BB的30.8%,QF的46.2%.
结论:
- 超声波可以有效地评估重症儿童的肌肉厚度.
- 肌肉缩在重症儿童中很普遍,特别是在PICU住院的第二周.
- 通过超声波进行定期的肌肉监测对于识别这种人群的肌肉损失至关重要.
相关概念视频
Disorders of the Skeletal Muscle
905
The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
905
Acute Respiratory Failure-II
186
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
186
Skeletal Muscle Relaxants: Adverse Effects
348
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
348
Muscle Recovery and Fatigue
2.0K
Muscle fatigue refers to the decline in a muscle's ability to maintain the force of contraction after prolonged activity. It primarily stems from changes within muscle fibers. Even before experiencing muscle fatigue, one may feel tired and have the urge to stop the activity. This response, known as central fatigue, occurs due to changes in the central nervous system, namely the brain and spinal cord. While there is no single mechanism that induces fatigue, it may serve as a protective...
2.0K
Myasthenia Gravis: Diagnostic Tests
705
Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
705
Acute Respiratory Failure-III
163
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
163


