• Formenti Paolo, De Giorgis Valentina, Coppola Silvia, Pozzi Tommaso, Chiodaroli Elena, Dres Martin, J Marini John, and Chiumello Davide.
• SC Anestesia e Rianimazione, Ospedale San Paolo - Polo Universitario, ASST Santi Paolo e Carlo, Milan, Italy. Electronic address: formenti.paolo80@gmail.com.
• J Crit Care. 2022 Oct 1; 71: 154104.

PurposeIntensive Care Unit acquired weakness (ICUAW) occurs commonly. Muscular ultrasonography allows visualization and classification of muscle characteristics. The aims of this study were to evaluate peripheral and respiratory muscles, their changes during long-term ICU stays, and the possible diagnostic predictive value of ICUAW as compared to the Medical Research Council strength score (MRC-SS).Materials50 mechanically ventilated patients were enrolled. Within 48 h after ICU admission (T1), patients underwent muscular ultrasound (rectus femoris cross sectional area (RFCSA), pennation angle, diaphragm, and parasternal intercostal). All the same measures were repeated at days 3 (T3) and 7 (T7). Muscle strength assessment was performed using the MRC-SS.ResultsNo significant differences were found regarding age, sex, weight, height, or BMI values, in those who developed ICUAW according to MRC-SS. The RF pennation angle, however, significantly changed between T7-T1 in patients who developed ICUAW and was. Found to be the best predictor of ICUAW.ConclusionsQuadriceps and respiratory muscles were altered within the first week of mechanical ventilation. The loss of pennation angle offers high diagnostic accuracy for ICUAW, allowing for an earlier diagnosis before patients became able to perform volitional tests.Copyright © 2022 Elsevier Inc. All rights reserved.

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