Nonvolitional assessment of tibialis anterior force and architecture during critical illness

TY - JOUR

T1 - Nonvolitional assessment of tibialis anterior force and architecture during critical illness

AU - Connolly, Bronwen

AU - Maddocks, Matthew

AU - Macbean, Victoria

AU - Bernal, William

AU - Hart, Nicholas

AU - Hopkins, Philip

AU - Rafferty, Gerrard F.

N1 - © 2017 Wiley Periodicals, Inc.

PY - 2018/6

Y1 - 2018/6

N2 - Introduction: Contemporaneous measures of muscle architecture and force have not previously been conducted during critical illness to examine their relationship with intensive care unit (ICU)-acquired weakness. Methods: Ankle dorsiflexor muscle force (ADMF) with high-frequency electrical peroneal nerve stimulation and skeletal muscle architecture via ultrasound were measured in 21 adult, critically ill patients, 16 at ICU admission. Results: Thirteen patients were measured on 2 occasions. Among these, 10 who were measured at ICU admission demonstrated muscle weakness. Despite significant reductions in tibialis anterior (Δ = -88.5 ± 78.8 mm2, P = 0.002) and rectus femoris (Δ = -126.1 ± 129.1 mm2, P = 0.006) cross-sectional areas between occasions, ADMF did not change (100-HZ ankle dorsiflexor force 9.8 [IQR, 8.0-14.4] kg vs. 8.6 (IQR, 6.7-19.2) kg, P = 0.9). Discussion: Muscle weakness was evident at ICU admission. No additional decrements were observed 7 days later despite significant reductions in muscle size. These data suggest that not all ICU weakness is truly "acquired" and questions our understanding of muscle function during critical illness.

AB - Introduction: Contemporaneous measures of muscle architecture and force have not previously been conducted during critical illness to examine their relationship with intensive care unit (ICU)-acquired weakness. Methods: Ankle dorsiflexor muscle force (ADMF) with high-frequency electrical peroneal nerve stimulation and skeletal muscle architecture via ultrasound were measured in 21 adult, critically ill patients, 16 at ICU admission. Results: Thirteen patients were measured on 2 occasions. Among these, 10 who were measured at ICU admission demonstrated muscle weakness. Despite significant reductions in tibialis anterior (Δ = -88.5 ± 78.8 mm2, P = 0.002) and rectus femoris (Δ = -126.1 ± 129.1 mm2, P = 0.006) cross-sectional areas between occasions, ADMF did not change (100-HZ ankle dorsiflexor force 9.8 [IQR, 8.0-14.4] kg vs. 8.6 (IQR, 6.7-19.2) kg, P = 0.9). Discussion: Muscle weakness was evident at ICU admission. No additional decrements were observed 7 days later despite significant reductions in muscle size. These data suggest that not all ICU weakness is truly "acquired" and questions our understanding of muscle function during critical illness.

KW - Architecture

KW - Assessment

KW - Critical illness

KW - Muscle force

KW - Ultrasound

UR - http://www.scopus.com/inward/record.url?scp=85042663429&partnerID=8YFLogxK

U2 - 10.1002/mus.26049

DO - 10.1002/mus.26049

M3 - Article

C2 - 29266337

SN - 0148-639X

VL - 57

SP - 964

EP - 972

JO - Muscle and Nerve

JF - Muscle and Nerve

IS - 6

ER -