Value of Skeletal Muscle Ultrasonography in The Assessment of Critical Illness Myopathy in Patients with Weaning Failure from Mechanical Ventilation

Abstract

Background: In critically ill cases, muscle strength evaluation is often delayed due to impaired attentiveness or consciousness, which may be caused by delirium or sedation.

Aim: To evaluate the role of muscle ultrasound (echogenicity, muscle thickness, and length) in the diagnosis of critical disease neuromyopathy compared to nerve conduction studies (NCS).

Patients and methods: This prospective research has been performed in the Critical Care Unit of Kasr Al-Ainy Hospital, Cairo University. The present study included fifty critically ill cases that were admitted to the intensive care unit from June 2021 to January 2023 and experienced failure of weaning from mechanical ventilation during their ICU course.

Results: Ultrasonography tests on the diaphragm and quadriceps femoris muscles showed that the diaphragm moved an average of 1.99 cm and the quadriceps femoris muscle was 32.78 cm thick. Most of the people who were studied had grade I muscle echogenicity (62%). The mean muscle strength assessment (MRC) scale was 3.66, while the mean APACHE II score was 20.22, and 19 patients died.

Conclusion: Bedside ultrasonography may be very beneficial for diagnosing and evaluating cases of intensive care unit acquired weakness (ICUAW) in the ICU. Combining muscle echogenicity and dimensions is useful in the detection of muscle alterations through the course of critical disease and may be utilized as a screening tool.