Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study

Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We...
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Gespeichert in:

Autor*in:	Witteveen, Esther [verfasserIn] Sommers, Juultje [verfasserIn] Wieske, Luuk [verfasserIn] Doorduin, Jonne [verfasserIn] van Alfen, Nens [verfasserIn] Schultz, Marcus J. [verfasserIn] van Schaik, Ivo N. [verfasserIn] Horn, Janneke [verfasserIn] Verhamme, Camiel [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2017

Schlagwörter:	ICU-AW Critical illness myopathy Critical illness polyneuropathy Critical illness neuromyopathy Neuromuscular ultrasound Diagnosis

Übergeordnetes Werk:	Enthalten in: Annals of intensive care - Heidelberg : Springer, 2011, 7(2017), 1 vom: 05. Apr.
Übergeordnetes Werk:	volume:7 ; year:2017 ; number:1 ; day:05 ; month:04

Links:	Volltext

DOI / URN:	10.1186/s13613-017-0263-8

Katalog-ID:	SPR031930263

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520			\|a Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW. Methods Newly admitted ICU patients, mechanically ventilated for at least 48 h, were included. As soon as patients were awake and attentive, an ultrasound was made of four muscles and two nerves (index test) and ICU-AW was evaluated using muscle strength testing (reference standard; ICU-AW defined as mean Medical Research Council score <4). Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. Conclusion Neuromuscular ultrasound does not discriminate between patients with and without ICU-AW at the time the patient awakens and is therefore not able to reliably diagnose ICU-AW in ICU patients relatively early in the disease course.
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700	1		\|a Verhamme, Camiel \|e verfasserin \|4 aut
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allfields	10.1186/s13613-017-0263-8 doi (DE-627)SPR031930263 (SPR)s13613-017-0263-8-e DE-627 ger DE-627 rakwb eng 610 ASE Witteveen, Esther verfasserin aut Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW. Methods Newly admitted ICU patients, mechanically ventilated for at least 48 h, were included. As soon as patients were awake and attentive, an ultrasound was made of four muscles and two nerves (index test) and ICU-AW was evaluated using muscle strength testing (reference standard; ICU-AW defined as mean Medical Research Council score <4). Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. Conclusion Neuromuscular ultrasound does not discriminate between patients with and without ICU-AW at the time the patient awakens and is therefore not able to reliably diagnose ICU-AW in ICU patients relatively early in the disease course. ICU-AW (dpeaa)DE-He213 Critical illness myopathy (dpeaa)DE-He213 Critical illness polyneuropathy (dpeaa)DE-He213 Critical illness neuromyopathy (dpeaa)DE-He213 Neuromuscular ultrasound (dpeaa)DE-He213 Diagnosis (dpeaa)DE-He213 Sommers, Juultje verfasserin aut Wieske, Luuk verfasserin aut Doorduin, Jonne verfasserin aut van Alfen, Nens verfasserin aut Schultz, Marcus J. verfasserin aut van Schaik, Ivo N. verfasserin aut Horn, Janneke verfasserin aut Verhamme, Camiel verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 7(2017), 1 vom: 05. Apr. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:7 year:2017 number:1 day:05 month:04 https://dx.doi.org/10.1186/s13613-017-0263-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2017 1 05 04
spelling	10.1186/s13613-017-0263-8 doi (DE-627)SPR031930263 (SPR)s13613-017-0263-8-e DE-627 ger DE-627 rakwb eng 610 ASE Witteveen, Esther verfasserin aut Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW. Methods Newly admitted ICU patients, mechanically ventilated for at least 48 h, were included. As soon as patients were awake and attentive, an ultrasound was made of four muscles and two nerves (index test) and ICU-AW was evaluated using muscle strength testing (reference standard; ICU-AW defined as mean Medical Research Council score <4). Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. Conclusion Neuromuscular ultrasound does not discriminate between patients with and without ICU-AW at the time the patient awakens and is therefore not able to reliably diagnose ICU-AW in ICU patients relatively early in the disease course. ICU-AW (dpeaa)DE-He213 Critical illness myopathy (dpeaa)DE-He213 Critical illness polyneuropathy (dpeaa)DE-He213 Critical illness neuromyopathy (dpeaa)DE-He213 Neuromuscular ultrasound (dpeaa)DE-He213 Diagnosis (dpeaa)DE-He213 Sommers, Juultje verfasserin aut Wieske, Luuk verfasserin aut Doorduin, Jonne verfasserin aut van Alfen, Nens verfasserin aut Schultz, Marcus J. verfasserin aut van Schaik, Ivo N. verfasserin aut Horn, Janneke verfasserin aut Verhamme, Camiel verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 7(2017), 1 vom: 05. Apr. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:7 year:2017 number:1 day:05 month:04 https://dx.doi.org/10.1186/s13613-017-0263-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2017 1 05 04
allfields_unstemmed	10.1186/s13613-017-0263-8 doi (DE-627)SPR031930263 (SPR)s13613-017-0263-8-e DE-627 ger DE-627 rakwb eng 610 ASE Witteveen, Esther verfasserin aut Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW. Methods Newly admitted ICU patients, mechanically ventilated for at least 48 h, were included. As soon as patients were awake and attentive, an ultrasound was made of four muscles and two nerves (index test) and ICU-AW was evaluated using muscle strength testing (reference standard; ICU-AW defined as mean Medical Research Council score <4). Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. Conclusion Neuromuscular ultrasound does not discriminate between patients with and without ICU-AW at the time the patient awakens and is therefore not able to reliably diagnose ICU-AW in ICU patients relatively early in the disease course. ICU-AW (dpeaa)DE-He213 Critical illness myopathy (dpeaa)DE-He213 Critical illness polyneuropathy (dpeaa)DE-He213 Critical illness neuromyopathy (dpeaa)DE-He213 Neuromuscular ultrasound (dpeaa)DE-He213 Diagnosis (dpeaa)DE-He213 Sommers, Juultje verfasserin aut Wieske, Luuk verfasserin aut Doorduin, Jonne verfasserin aut van Alfen, Nens verfasserin aut Schultz, Marcus J. verfasserin aut van Schaik, Ivo N. verfasserin aut Horn, Janneke verfasserin aut Verhamme, Camiel verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 7(2017), 1 vom: 05. Apr. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:7 year:2017 number:1 day:05 month:04 https://dx.doi.org/10.1186/s13613-017-0263-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2017 1 05 04
allfieldsGer	10.1186/s13613-017-0263-8 doi (DE-627)SPR031930263 (SPR)s13613-017-0263-8-e DE-627 ger DE-627 rakwb eng 610 ASE Witteveen, Esther verfasserin aut Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW. Methods Newly admitted ICU patients, mechanically ventilated for at least 48 h, were included. As soon as patients were awake and attentive, an ultrasound was made of four muscles and two nerves (index test) and ICU-AW was evaluated using muscle strength testing (reference standard; ICU-AW defined as mean Medical Research Council score <4). Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. Conclusion Neuromuscular ultrasound does not discriminate between patients with and without ICU-AW at the time the patient awakens and is therefore not able to reliably diagnose ICU-AW in ICU patients relatively early in the disease course. ICU-AW (dpeaa)DE-He213 Critical illness myopathy (dpeaa)DE-He213 Critical illness polyneuropathy (dpeaa)DE-He213 Critical illness neuromyopathy (dpeaa)DE-He213 Neuromuscular ultrasound (dpeaa)DE-He213 Diagnosis (dpeaa)DE-He213 Sommers, Juultje verfasserin aut Wieske, Luuk verfasserin aut Doorduin, Jonne verfasserin aut van Alfen, Nens verfasserin aut Schultz, Marcus J. verfasserin aut van Schaik, Ivo N. verfasserin aut Horn, Janneke verfasserin aut Verhamme, Camiel verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 7(2017), 1 vom: 05. Apr. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:7 year:2017 number:1 day:05 month:04 https://dx.doi.org/10.1186/s13613-017-0263-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2017 1 05 04
allfieldsSound	10.1186/s13613-017-0263-8 doi (DE-627)SPR031930263 (SPR)s13613-017-0263-8-e DE-627 ger DE-627 rakwb eng 610 ASE Witteveen, Esther verfasserin aut Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW. Methods Newly admitted ICU patients, mechanically ventilated for at least 48 h, were included. As soon as patients were awake and attentive, an ultrasound was made of four muscles and two nerves (index test) and ICU-AW was evaluated using muscle strength testing (reference standard; ICU-AW defined as mean Medical Research Council score <4). Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. Conclusion Neuromuscular ultrasound does not discriminate between patients with and without ICU-AW at the time the patient awakens and is therefore not able to reliably diagnose ICU-AW in ICU patients relatively early in the disease course. ICU-AW (dpeaa)DE-He213 Critical illness myopathy (dpeaa)DE-He213 Critical illness polyneuropathy (dpeaa)DE-He213 Critical illness neuromyopathy (dpeaa)DE-He213 Neuromuscular ultrasound (dpeaa)DE-He213 Diagnosis (dpeaa)DE-He213 Sommers, Juultje verfasserin aut Wieske, Luuk verfasserin aut Doorduin, Jonne verfasserin aut van Alfen, Nens verfasserin aut Schultz, Marcus J. verfasserin aut van Schaik, Ivo N. verfasserin aut Horn, Janneke verfasserin aut Verhamme, Camiel verfasserin aut Enthalten in Annals of intensive care Heidelberg : Springer, 2011 7(2017), 1 vom: 05. Apr. (DE-627)664260918 (DE-600)2617094-2 2110-5820 nnns volume:7 year:2017 number:1 day:05 month:04 https://dx.doi.org/10.1186/s13613-017-0263-8 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2017 1 05 04
language	English
source	Enthalten in Annals of intensive care 7(2017), 1 vom: 05. Apr. volume:7 year:2017 number:1 day:05 month:04
sourceStr	Enthalten in Annals of intensive care 7(2017), 1 vom: 05. Apr. volume:7 year:2017 number:1 day:05 month:04
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	ICU-AW Critical illness myopathy Critical illness polyneuropathy Critical illness neuromyopathy Neuromuscular ultrasound Diagnosis
dewey-raw	610
isfreeaccess_bool	true
container_title	Annals of intensive care
authorswithroles_txt_mv	Witteveen, Esther @@aut@@ Sommers, Juultje @@aut@@ Wieske, Luuk @@aut@@ Doorduin, Jonne @@aut@@ van Alfen, Nens @@aut@@ Schultz, Marcus J. @@aut@@ van Schaik, Ivo N. @@aut@@ Horn, Janneke @@aut@@ Verhamme, Camiel @@aut@@
publishDateDaySort_date	2017-04-05T00:00:00Z
hierarchy_top_id	664260918
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Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. 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author	Witteveen, Esther
spellingShingle	Witteveen, Esther ddc 610 misc ICU-AW misc Critical illness myopathy misc Critical illness polyneuropathy misc Critical illness neuromyopathy misc Neuromuscular ultrasound misc Diagnosis Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study
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topic_title	610 ASE Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study ICU-AW (dpeaa)DE-He213 Critical illness myopathy (dpeaa)DE-He213 Critical illness polyneuropathy (dpeaa)DE-He213 Critical illness neuromyopathy (dpeaa)DE-He213 Neuromuscular ultrasound (dpeaa)DE-He213 Diagnosis (dpeaa)DE-He213
topic	ddc 610 misc ICU-AW misc Critical illness myopathy misc Critical illness polyneuropathy misc Critical illness neuromyopathy misc Neuromuscular ultrasound misc Diagnosis
topic_unstemmed	ddc 610 misc ICU-AW misc Critical illness myopathy misc Critical illness polyneuropathy misc Critical illness neuromyopathy misc Neuromuscular ultrasound misc Diagnosis
topic_browse	ddc 610 misc ICU-AW misc Critical illness myopathy misc Critical illness polyneuropathy misc Critical illness neuromyopathy misc Neuromuscular ultrasound misc Diagnosis
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title	Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study
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title_full	Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study
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author_browse	Witteveen, Esther Sommers, Juultje Wieske, Luuk Doorduin, Jonne van Alfen, Nens Schultz, Marcus J. van Schaik, Ivo N. Horn, Janneke Verhamme, Camiel
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title_sort	diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study
title_auth	Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study
abstract	Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW. Methods Newly admitted ICU patients, mechanically ventilated for at least 48 h, were included. As soon as patients were awake and attentive, an ultrasound was made of four muscles and two nerves (index test) and ICU-AW was evaluated using muscle strength testing (reference standard; ICU-AW defined as mean Medical Research Council score <4). Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. Conclusion Neuromuscular ultrasound does not discriminate between patients with and without ICU-AW at the time the patient awakens and is therefore not able to reliably diagnose ICU-AW in ICU patients relatively early in the disease course.
abstractGer	Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW. Methods Newly admitted ICU patients, mechanically ventilated for at least 48 h, were included. As soon as patients were awake and attentive, an ultrasound was made of four muscles and two nerves (index test) and ICU-AW was evaluated using muscle strength testing (reference standard; ICU-AW defined as mean Medical Research Council score <4). Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. Conclusion Neuromuscular ultrasound does not discriminate between patients with and without ICU-AW at the time the patient awakens and is therefore not able to reliably diagnose ICU-AW in ICU patients relatively early in the disease course.
abstract_unstemmed	Background Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW. Methods Newly admitted ICU patients, mechanically ventilated for at least 48 h, were included. As soon as patients were awake and attentive, an ultrasound was made of four muscles and two nerves (index test) and ICU-AW was evaluated using muscle strength testing (reference standard; ICU-AW defined as mean Medical Research Council score <4). Diagnostic accuracy of muscle thickness, echo intensity and homogeneity (echo intensity standard deviation) as well as nerve cross-sectional area, thickness and vascularization were evaluated with the area under the curve of the receiver operating characteristic curve (ROC–AUC). We also evaluated diagnostic accuracy of z-scores of muscle thickness, echo intensity and echo intensity standard deviation. Results Seventy-one patients were evaluated of whom 41 had ICU-AW. Ultrasound was done at a median of 7 days after admission in patients without ICU-AW and 9 days in patients with ICU-AW. Diagnostic accuracy of all muscle and nerve parameters was low. ROC–AUC ranged from 51.3 to 68.0% for muscle parameters and from 51.0 to 66.7% for nerve parameters. Conclusion Neuromuscular ultrasound does not discriminate between patients with and without ICU-AW at the time the patient awakens and is therefore not able to reliably diagnose ICU-AW in ICU patients relatively early in the disease course.
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title_short	Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study
url	https://dx.doi.org/10.1186/s13613-017-0263-8
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author2	Sommers, Juultje Wieske, Luuk Doorduin, Jonne van Alfen, Nens Schultz, Marcus J. van Schaik, Ivo N. Horn, Janneke Verhamme, Camiel
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