Can musculoskeletal ultrasound be used at the bedside in the ICU to predict adverse outcomes?


Ultrasound is being increasingly utilized by researchers in the areas of exercise physiology, biomechanics, and rehabilitation science. Part of the reason for this is its portability and ease of use. It hasn't necessarily been adopted by clinicians in hospital settings, however. Recent work by researchers at Harvard Medical School may change that. The study, published by Mueller et al. in Annals of Surgery, sought to determine if muscle size of the rectus femoris was able to provide similar predictability as the Frailty Index Questionnaire, which is a 50 item survey assessing attributes like independence, social support, and depression. 102 critically ill patients completed the study. Upon admission in the ICU, muscle cross-sectional area of the rectus femoris was determined and the patients completed the Frailty Index Questionnaire. The authors found that the muscle size measure and the questionnaire were equally effective in predicting whether a patient would be discharged to a skilled nursing facility versus in-hospital mortality. All of the patients that died in the hospital had been classified as sarcopenic based on the ultrasound data. The researchers concluded that ultrasound used at bedside during admission in the ICU was as effective as subjective assessment of frailty. The advantage of ultrasound, however, is that it is simple to perform and does not require cooperation from the patient.