ESPEN 2021 Late Breaking Abstracts

Topic: Critical care

Abstract Submission Identifier: ESPEN21-LB-1980

ASSESS OF ANTHROPOMETRIC MEASUREMENTS AND MUSCLE CHANGES IN THE CRITICALLY ILL TRAUMA PATIENTS

A. O. Küçük ¹, M. Kangalgil^*, ², S. Turan ¹, K. Öncü ¹, H. Ulusoy ¹

¹Department of Anesthesiology and Reanimation, Faculty of Medicine, Karadeniz Technical University, ²Department of Nutrition and Dietetics, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Türkiye

Rationale: The loss of skeletal muscle mass is associated with adverse outcomes in critically ill patients. This study aimed to examined rectus femoris muscle wasting and changes in anthropometric measurements in the first 7 days of admission to the intensive care unit for trauma patients.

Methods: This single-center, prospective, observational study included critically ill trauma and surgical patients aged 18-85 years and expected to the length of the intensive care unit for more than seven days. Ultrasound and anthropometric measurements were performed within 48 h of ICU admission (baseline) and seven days after. The rectus femoris cross-sectional area (CSA, in cm²) was measured using bedside ultrasound. European Society of Clinical Nutrition and Metabolism guidelines were used to energy and protein requirements.

Results: In total, thirty-five trauma patients were enrolled. The mean age of the patients was 49.6±18.6 (range 20–82) years; 71.4% were male. There was the association between baseline rectus femoris CSA and mid-upper  arm circumference (r=0.542, p<0.05) and calf circumference (r =0.454, p<0.05). There was significant reductions in the rectus femoris CSA (−16.7% [95% CI, −22.2% to −11.3%]; p <0.05); mid-upper arm circumference (-4.6% [95% CI, −7.3% to −1.9%; p <0.05)] and calf circumference (-3.3% [95% CI, −4.9% to −1.7%; p <0.05)] observed at day 7.

Conclusion: Rectus femoris CSA is associated with anthropometric measurements, however, changes in muscle mass are more severe than changes in anthropometric measurements. In critically ill trauma patients, muscle wasting occurs rapidly in the first week in the intensive care unit, and ultrasound of rectus femoris could represent a safe, simple, and non-invasive method to evaluate changes in skeletal muscle.

References: Simpson, F., Doig, G. S. (2016). Bedside nutrition evaluation and physical assessment techniques in critical illness. Current opinion in critical care, 22(4), 303-307.

Disclosure of Interest: None Declared

Keywords: anthropometric measurements, Critically ill patients, muscle ultrasonography