Muscle Atrophy Occurs Rapidly in Critically Ill, Ventilated Children

47 percent of cohort experienced ≥11 percent decrease in diaphragm thickness after six days

TUESDAY, Jan. 8, 2019 (HealthDay News) -- Children receiving invasive mechanical ventilation for ≥48 hours often experience muscle atrophy, especially in the diaphragm, according to a study published online Dec. 19 in PLOS ONE.

Ryan W. Johnson, M.P.H., from the Washington University School of Medicine in St. Louis, and colleagues conducted a prospective cohort study involving 34 critically ill children aged 1 week to 18 years with respiratory failure who were receiving invasive mechanical ventilation for ≥48 hours. Thirty of the participants completed two or more ultrasound assessments of muscle thickness for a median interval of six days.

In the entire cohort, researchers found an 11.1 percent decrease in diaphragm thickness between the first two assessments (2.2 percent/day); quadriceps thickness decreased by 8.62 percent (1.5 percent/day). There was no significant change in biceps or tibialis thickness. Forty-seven percent of the cohort experienced diaphragm atrophy (≥10 percent decrease in thickness), while 83 and 47 percent of patients experienced atrophy in at least one or at least two muscle groups, respectively. Increasing age and traumatic brain injury were correlated with greater muscle loss on multivariate linear regression.

"It will be important for future multicenter studies to explore how skeletal muscle loss in critically ill kids impacts their recovery," a coauthor said in a statement. "We know that adult patients with similarly weakened muscle tone take longer to wean from ventilators, have longer hospital stays, and face heightened mortality risk."

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