Abstract
BACKGROUND: The purpose of this study is to determine the interobserver reproducibility of the acquisition and analysis of thickness measurements and echogenicity quadriceps ultrasound in multiple trauma individuals on mechanical ventilation.
METHODS: Observational study was conducted in severe polytrauma subjects admitted in a tertiary trauma center hospital. Adults with expectation of being intubated for more than 48 hours were included. All sonograms were obtained from the right leg of patients, with a standardized protocol of transducer placement, anatomic landmarks, and patient position for acquisition. Muscle size was evaluated by: quadriceps and rectus femoris thickness. Muscle echogenicity was determined using computer-assisted (Image J) quantitative gray scale analysis and assessed in rectus femoris, selecting the region of interest by: square technique (RFsq) and trace technique (RFtr).
RESULTS: Excellent interobserver reliability was found for muscle thickness, both for quadriceps thickness - intraclass correlation coefficient (ICC) the 0.999 of 0.996. Analysis of muscle echogenicity also presented an excellent interobserver reliability for the two techniques with ICC the 0.987 to 0.999; however, the values of echogenicity the trace method showed a significant different value among the 3 assessors (p <0,0039).
CONCLUSION: Ultrasound is a reliable method to assess quadriceps muscle size and echogenicity at bedside in mechanically ventilated polytrauma patients. It is recommended that square technique should be used to select the region of interest to measure echogenicity in this population.
- Copyright ©the authors 2016
