Feasibility of Serial Ultrasound Measurements of the Rectus Femoris Muscle Area to Assess Muscle Loss in Patients Awaiting Liver Transplantation in the Intensive Care Unit

• Published in: Transplantation direct 2020-11, Vol.6 (11), p.e618-e618
• Main Authors: Pita, Alejandro, Ziogas, Ioannis A., Ye, Fei, Chen, Yufan, Rauf, Muhammad A., Matsuoka, Lea K., Kaur, Navpreet, Whang, Gilbert, Zielsdorf, Shannon M., Bastas, Gerasimos, Izzy, Manhal, Alexopoulos, Sophoclis P.
• Format: Article
• Language: English
• Subjects: Liver Transplantation
• ISSN: 2373-8731; 2373-8731
• DOI: 10.1097/TXD.0000000000001067

End-stage liver disease (ESLD) patients requiring intensive care unit (ICU) care before liver transplantation (LT) often experience significant muscle mass loss, which has been associated with mortality. In this exploratory study, we primarily aimed to assess the feasibility of serial ultrasound (US) rectus femoris muscle area (RFMA) measurements for the evaluation of progressive muscle loss in ICU-bound potential LT candidates and describe the rate of muscle loss as assessed by sequential US RFMA measurements. Secondarily, we sought to identify patient characteristics associated with muscle loss and determine how muscle loss is associated with survival. We prospectively enrolled 50 ESLD adults (≥18 y old) undergoing evaluation for LT candidacy in the ICU. A baseline computed tomography measurement of psoas muscle area (PMA) and serial bedside US measurements of RFMA were obtained. The associations between patient characteristics, PMA, RFMA, ICU stay, and survival were analyzed. Rapid decline in muscle mass by RFMA measurements was ubiquitously present and correlated to baseline PMA and length of ICU stay. RFMA normalized by body surface area decreased by 0.013 cm /m (95% confidence interval, 0.010-0.016;