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Dynamic tibialis anterior ultrasound monitoring reveals a multimodal ultrasound signature for intensive care unit-acquired weakness: A prospective cohort study.
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7 authors.
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Abstract
ObjectiveTo validate a serial multimodal ultrasound (MMUS) protocol for assessing dynamic tibialis anterior changes in detecting intensive care unit-acquired weakness (ICUAW) and to develop a diagnostic algorithm.MethodsIn a prospective cohort of 97 high-risk adults (mean age 60.7±13.7 years; 73.2% male; SOFA score ≥8 for ≥3 days), MMUS quantified structural (thickness, echogenicity), hemodynamic (perfusion grade, peak systolic velocity [PSV]), and mechanical (elastic modulus) parameters of the tibialis anterior at ICU admission (Day 1) and Day 7. ICUAW was diagnosed per American Thoracic Society guidelines. Serum biomarkers (IL-6, PCT, CRP) were correlated with sonographic changes. Diagnostic models were constructed using binary logistic regression and evaluated by ROC analysis.Results31 patients (32.0%) developed ICUAW. By Day 7, the ICUAW group showed greater structural deterioration (echogenicity progression: 54.8% vs. 16.7%,
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