Ultrasound assessment of muscle mass in extracorporeal membrane oxygenation patients and its correlation with clinical outcomes: A retrospective observational study.

OBJECTIVES

To explore the correlation between the parameters of muscle atrophy assessed by musculoskeletal ultrasound and the clinical outcomes of patients treated with extracorporeal membrane oxygenation (ECMO).

METHODS

Patients who received ECMO treatment in the emergency intensive care unit of the First Affiliated Hospital of Nanjing Medical University (Jiangsu Provincial Hospital) from August 2022 to December 2023 were selected as the study subjects. Patients were grouped based on the percentage reduction in the cross-sectional area of the rectus femoris muscle assessed by ultrasound, with a reduction of ≥10% classified into the muscle atrophy group and a reduction of <10% classified into the nonmuscle atrophy group. Basic clinical data, outcome data, clinical laboratory data, and physical measurements of ECMO patients were collected and analyzed to compare the overall clinical outcomes between the two groups.

RESULTS

A total of 45 ECMO patients were included in the study; 30 patients (66.67%) were included in the muscle atrophy group, 15 patients (33.33%) were included in the nonmuscle atrophy group, and the overall 28-day survival rate was 51.11%. The patients in the muscle atrophy group (57 [48.75, 61] years) were significantly older than those in the nonmuscle atrophy group (52 [31, 57] years, P = 0.028), whereas other basic clinical data, including sex, height, weight, body mass index, Acute Physiology and Chronic Health Evaluation II score, and ECMO mode, did not differ. The initial total protein value (56.44 ± 7.304) g/L and albumin value (32.61 ± 4.823) g/L in the muscle atrophy group were significantly lower than those in the nonmuscle atrophy group (total protein [61.44 ± 7.950] g/L, P = 0.041; albumin [37.17 ± 6.653] g/L, P = 0.012). The change in the psoas muscle area at the T3 level in the muscle atrophy group (-136.59 ± 72.950) mm2 was significantly less than that in the nonmuscle atrophy group ([-60.23 ± 26.934] mm2, P = 0.002), and other physical measurement data, including changes in midarm circumference and calf circumference, were not significantly different. There were no significant differences in the 28-day survival rate, ventilator-free time, or ICU stay time between the two groups of patients.

CONCLUSIONS

Muscle atrophy is relatively common in ECMO patients, and bedside ultrasound assessment of the muscle atrophy status of ECMO patients has a certain degree of reliability. However, the relationship between the occurrence of muscle atrophy and patient prognosis is not clear and requires further verification.