title: Quantitative neuromuscular ultrasound in the intensive care unit.
abstract: BACKGROUND
  Intensive care unit acquired weakness (ICU-AW) results from a complex mixture of nerve and muscle pathology, and early identification is challenging. This pilot study was designed to examine the ultrasonographic changes that occur in muscles during ICU hospitalization.
  
  
  METHODS
  Patients admitted to the ICU for acute respiratory failure were enrolled prospectively and underwent serial muscle ultrasound for thickness and gray-scale assessment of the tibialis anterior, rectus femoris, abductor digiti minimi, biceps, and diaphragm muscles over 14 days.
  
  
  RESULTS
  Sixteen participants were enrolled. The tibialis anterior (P = 0.001) and rectus femoris (P = 0.041) had significant decreases in gray-scale standard deviation when analyzed over 14 days. No muscles showed significant changes in thickness.
  
  
  CONCLUSIONS
  Ultrasound is an informative technique for assessing muscles of patients in the ICU, and lower extremity muscles demonstrated increased homogeneity during ICU stays. This technique should be examined further for diagnosing and tracking those with ICU-AW.
authors.affiliation: Department of Neurology, Wake Forest University School of Medicine, Reynolds Tower, Winston-Salem, North Carolina 27157, USA. mcartwri@wakehealth.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Cartwright
authors.forename: Golda
authors.initials: G
authors.lastname: Kwayisi
authors.forename: Leah P
authors.initials: LP
authors.lastname: Griffin
authors.forename: Aarti
authors.initials: A
authors.lastname: Sarwal
authors.forename: Francis O
authors.initials: FO
authors.lastname: Walker
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Harris
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Berry
authors.forename: Preet S
authors.initials: PS
authors.lastname: Chahal
authors.forename: Peter E
authors.initials: PE
authors.lastname: Morris
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000000981:diagnostic imaging; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging*; D010865:Pilot Projects; D012131:Respiratory Insufficiency / Q000000981:diagnostic imaging*; D014463:Ultrasonography