• Ming-Chieh Yang, Yung-Chang Wang, I-Shu Chen, and Wei-Chun Huang.
• From the Division of Critical Care Medicine, E-Da Cancer Hospital (M-CY), Department of Surgery, Kaohsiung Veterans General Hospital (I-SC), Department of Critical Care Medicine, Kaohsiung Veterans General Hospital (Y-CW, W-CH), School of Medicine, National Yang-Ming University (M-CY, W-CH) and Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan (W-CH).
• Eur J Anaesthesiol. 2021 Jul 1; 38 (7): 684691684-691.

BackgroundEarly identification of patients at high risk of prolonged mechanical ventilation is important in critical care. Sarcopenia, the loss of muscle mass and function, has been reported to be associated with extended mechanical ventilation and prolonged ICU stay. Although ultrasound is noninvasive and widely used in critical care, there is no standard method of using it to assess sarcopenia.ObjectivesThe study aims to investigate the relationship between outcomes of critically ill patients and the ratio of BMI to the thickness of rectus abdominis measured by a standardised ultrasound examination.DesignA retrospective cohort study.SettingSurgical ICU of a tertiary referral hospital, from October 2017 to June 2018. The thickness of rectus abdominis (RA) was measured while performing extended focused assessment sonography for trauma. BMI was divided by the thickness of rectus abdominis over the upper abdomen to derive the BMI-RA thickness ratio.PatientsSixteen male and 11 female patients admitted to ICU after major abdominal surgery.Main Outcome MeasuresThe primary outcome was in-hospital mortality, and the secondary outcomes were durations of mechanical ventilation, ICU stay and hospital stay. The disease severity, serum albumin level and BMI-RA thickness ratio were also analysed.ResultsUltrasound measurement was easy to perform without adverse effects. The BMI-RA thickness ratio was significantly higher in nonsurvivors and was associated with ICU stay, hospital stay and duration of mechanical ventilation. Multivariable logistic regression showed that the BMI-RA thickness ratio was a predictor of in-hospital mortality.ConclusionThe BMI-RA thickness ratio is related to the outcomes of patients transferred to ICU after major abdominal surgery. Measuring the thickness of rectus abdominis by ultrasound is well tolerated and easy to perform in surgical ICU. Larger prospective studies are required to confirm current findings.Copyright © 2021 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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