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Systematic review on methods to determine muscle size & wasting in intensive care units (BSc Thesis)

13.09.2021, Diplomarbeiten, Bachelor- und Masterarbeiten

Intensive care unit (ICU)-acquired weakness can result from a loss of up to 18% of muscle mass within one week (Puthucheary et al., 2013). Such a dramatic loss of muscle mass and function is a major but underdiagnosed and undertreated problem because ICU-acquired weakness at discharge is a predictor of long-term mortality, poor physical function and health-related quality of life up until five years afterwards (Hermans et al., 2014; Van Aerde et al., 2020).

A major challenge is the measurement of muscle size and/or mass as e.g. MRI-scans of specific muscles or a whole body DEXA-scan are impossible. Moreover, e.g. muscle swelling due to oedema may mask muscle wasting despite a loss of myosin and actin. The aim of the proposed project is therefore to conduct a systematic search for studies that have used imaging, biopsy, biochemical and other methods to investigate skeletal muscle critically ill patients in ICU units. In the second step, an expert panel of ICU-physicians, muscle researchers and imaging experts will give best practice recommendations on how to measure ICU-acquired muscle weakness and highlight issues such as oedema. We will also come up with a methods wish list.

References: Hermans, G., De Jonghe, B., Bruyninckx, F., and Van den Berghe, G. (2014). Interventions for preventing critical illness polyneuropathy and critical illness myopathy. Cochrane Database of Systematic Reviews. Puthucheary, Z.A., Rawal, J., McPhail, M., Connolly, B., Ratnayake, G., Chan, P., Hopkinson, N.S., Padhke, R., Dew, T., Sidhu, P.S., et al. (2013). Acute Skeletal Muscle Wasting in Critical Illness. JAMA : the journal of the American Medical Association. Van Aerde, N., Van den Berghe, G., Wilmer, A., Gosselink, R., and Hermans, G. (2020). Intensive care unit acquired muscle weakness in COVID-19 patients. Intensive care medicine 46, 2083-2085.

Kontakt: henning.wackerhage@tum.de

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