--------------------
- Real-time shear wave ultrasound elastography: a new tool for the evaluation of diaphragm and limb muscle stiffness in critically ill patients doi link

Auteur(s): Flattres Aurelien, Aarab Yassir, Nougaret Stéphanie, Garnier Fanny, Larcher R., Amalric Mathieu, Klouche Kada, Etienne P., Subra Gilles, Jaber Samir, Molinari Nicolas, Matecki Stefan, Jung Boris

(Article) Publié: Critical Care, vol. 24 p.34 (2020)
Texte intégral en Openaccess : openaccess


Ref HAL: hal-02468739_v1
PMID 32014005
DOI: 10.1186/s13054-020-2745-6
WoS: 000513681200003
Exporter : BibTex | endNote
2 Citations
Résumé:

Background; Muscle weakness following critical illness is the consequence of loss of muscle mass and alteration of muscle quality. It is associated with long-term disability. Ultrasonography is a reliable tool to quantify muscle mass, but studies that evaluate muscle quality at the critically ill bedside are lacking. Shear wave ultrasound elastography (SWE) provides spatial representation of soft tissue stiffness and measures of muscle quality. The reliability and reproducibility of SWE in critically ill patients has never been evaluated.Methods; Two operators tested in healthy controls and in critically ill patients the intra- and inter-operator reliability of the SWE using transversal and longitudinal views of the diaphragm and limb muscles. Reliability was calculated using the intra-class correlation coefficient and a bootstrap sampling method assessed their consistency.Results: We collected 560 images. Longitudinal views of the diaphragm (ICC 0.83 [0.50–0.94]), the biceps brachii (ICC 0.88 [0.67–0.96]) and the rectus femoris (ICC 0.76 [0.34–0.91]) were the most reliable views in a training set of healthy controls. Intra-class correlation coefficient for inter-operator reproducibility and intra-operator reliability was above 0.9 for all muscles in a validation set of healthy controls. In critically ill patients, inter-operator reproducibility and intra-operator 1 and 2 reliability ICCs were respectively 0.92 [0.71–0.98], 0.93 [0.82–0.98] and 0.92 [0.81–0.98] for the diaphragm; 0.96 [0.86–0.99], 0.98 [0.94–0.99] and 0.99 [0.96–1] for the biceps brachii and 0.91 [0.51–0.98], 0.97 [0.93–0.99] and 0.99 [0.97–1] for the rectus femoris. The probability to reach intra-class correlation coefficient greater than 0.8 in a 10,000 bootstrap sampling for inter-operator reproducibility was respectively 81%, 84% and 78% for the diaphragm, the biceps brachii and the rectus femoris respectively.Conclusions: SWE is a reliable technique to evaluate limb muscles and the diaphragm in both healthy controls and in critically ill patients.



Commentaires: Une correction de cet article a été publiée in:Crit Care. 2020; 24: 79.Published online 2020 Mar 5. doi: 10.1186/s13054-020-2802-1 PMID:32138763In the publication of this article, there was an error in the Family Name of one of the authors. This has now been updated in the original article.The error: FlattresShould instead read: Flatres