PP181 - QUADRICEPS MUSCLE LOSS DURING THE FIRST 10 DAYS OF ICU STAY AND ITS ASSOCIATION WITH CLINICAL OUTCOMES: A PROSPECTIVE STUDY

PP181

QUADRICEPS MUSCLE LOSS DURING THE FIRST 10 DAYS OF ICU STAY AND ITS ASSOCIATION WITH CLINICAL OUTCOMES: A PROSPECTIVE STUDY

C. F. Burgel¹, L. W. de Echabe², A. O. Kampmann ¹, F. M. Silva^3,* on behalf of Nutrição Clínica Baseada em evidências

¹Registered Dietitian. PhD Student at Health Science Postgraduate Program, ²Registered Dietitian. Master Student at Health Science Postgraduate Program, ³Nutrition, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil

Rationale: Skeletal muscle loss occurs rapidly during critical illness and is associated with poor outcomes. However, the prognostic value of early muscle depletion assessed by ultrasound during ICU stay remains uncertain.

Methods: This prospective cohort study included adults (≥18 years) admitted to a general ICU and followed for 10 days. Quadriceps muscle layer thickness (QMLT) was measured using bedside ultrasound at admission, day 5, and day 10. Muscle loss was expressed as percentage change from baseline, and patients were categorized as <20% or ≥20% QMLT decline. Sociodemographic, nutritional, and clinical data were collected. Outcomes included duration of invasive mechanical ventilation (IMV), ICU and hospital length of stay (LOS), mortality, ICU-acquired weakness, and functional status at ICU discharge. Group comparisons were performed using appropriate statistical tests.

Results: Of 415 enrolled patients, 94 were reassessed at day 10 (mean age 61.5 ± 16.8 years; 52.1% male). The mean QMLT change was −14.4 ± 20.0%, corresponding to a daily loss of 1.86%. Among patients with muscle loss (n=77), 43 (55.8%) had <20% decline (−11.44%; IQR −16.25 to −6.37) and 34 (44.2%) had ≥20% decline (−31.47%; IQR −38.02 to −26.07). Active smoking was more frequent in patients with ≥20% loss, who also presented longer IMV duration. No significant differences were observed between groups regarding ICU or hospital length of stay, mortality, ICU-acquired weakness, or functional status at discharge.

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Conclusion: Significant quadriceps muscle loss occurs during the first 10 days of ICU stay. Although greater muscle depletion was associated with longer mechanical ventilation, it was not independently associated with other clinical or functional outcomes. These findings highlight the complexity of muscle loss assessment and its prognostic interpretation in critically ill patients.

Disclosure of Interest: None declared