Ultrasonography in the intensive care setting can be used to detect changes in the quality and quantity of muscle and is related to muscle strength and function

Selina M. Parry, Doa El-Ansary, Michael S. Cartwright, Aarti Sarwal, Sue Berney, René Koopman, Raquel Annoni, Zudin Puthucheary, Ian R. Gordon, Peter E. Morris, Linda Denehy

Research output: Contribution to journalArticlepeer-review

237 Scopus citations


Purpose: This study aimed to (1) document patterns of quadriceps muscle wasting in the first 10 days of admission and (2) determine the relationship between muscle ultrasonography and volitional measures. Materials and methods: Twenty-two adults ventilated for more than 48 hours were included. Sequential quadriceps ultrasound images were obtained over the first 10 days and at awakening and intensive care unit (ICU) discharge. Muscle strength and function were assessed at awakening and ICU discharge. Results: A total of 416 images were analyzed. There was a 30% reduction in vastus intermedius (VI) thickness, rectus femoris (RF) thickness, and cross-sectional area within 10 days of admission. Muscle echogenicity scores increased for both RF and VI muscles by + 12.7% and + 25.5%, respectively (suggesting deterioration in muscle quality). There was a strong association between function and VI thickness (r = 0.82) and echogenicity (r = - 0.77). There was a moderate association between function and RF cross-sectional area (r = 0.71). Conclusions: Muscle wasting occurs rapidly in the ICU setting. Ultrasonography is a useful surrogate measure for identifying future impairment. Vastus intermedius may be an important muscle to monitor in the future because it demonstrated the greatest change in muscle quality and had the strongest relationship to volitional measures.

Original languageEnglish
Pages (from-to)1151.e9-1151.e14
JournalJournal of Critical Care
Issue number5
StatePublished - Oct 1 2015

Bibliographical note

Funding Information:
Sources of funding and conflicts of interest: This research has been undertaken by SP (primary author) as part of her doctoral qualification with the support of the National Health and Medical Research Council Dora Lush Scholarship ( 103923 ). Author RK is currently in receipt of a CR Roper Fellowship , and author SB is a recipient of a National Health and Medical Research Council Fellowship . Authors RK, SB, and LD are in receipt of National Health and Medical Research Council project grants. None of the funding bodies and fellowships were involved or influenced the design or publication of this study. On behalf of all authors, the corresponding author states that there is no conflict of interest.

Publisher Copyright:
© 2015 Elsevier Inc.


  • Critical illness
  • Echogenicity
  • Intensive care
  • Intensive care unit-acquired weakness
  • Muscle wasting
  • Ultrasound

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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