• Carla Cristina de Araújo Alves, Priscilla Flavia de Melo, Luciana Vieira, Sunita Mathur, Chris Burtin, Vinicius Z Maldaner, Joao Luiz Q Durigan, Carla Nunes de Araujo, Vinicius Carolino de Souza, Graziella França Bernardelli Cipriano, Gaspar R Chiappa, Glauco Lima Rodrigues, Paulo Eugênio Silva, and Gerson Cipriano Junior.
• Faculty of Ceilândia, Sciences and Technologies in Health Program, University of Brasilia, Brasilia, DF, Brazil. dearaujo.carlacristina@gmail.com.
• Eur J Trauma Emerg Surg. 2025 Feb 7; 51 (1): 9393.

PurposeThe present study aims to describe initial changes in muscle thickness and composition, muscle growth signaling mediators, and systemic inflammation in critically ill patients after major trauma.MethodsThis observational study was carried out in a Level-I nonprofit trauma center. Thirty adults requiring mechanical ventilation were assessed within 24 h post-admission. Skeletal muscle wasting was evaluated using ultrasound for muscle thickness and echogenicity along with circulating insulin-like growth factor 1 (IGF-1) and inflammatory cytokines over five consecutive days. Changes over time were assessed using ANOVA repeated-measures analysis with a Bonferroni post-hoc test. Bivariate correlations were evaluated using Pearson or Spearman coefficients.ResultsOver five days, a significant decrease (11%) in rectus femoris thickness (3.91 ± 0.86 to 3.47 ± 0.64, cm, p = 0.01) and an increase (29%) in echogenicity (62.1 ± 13.1 to 80.4 ± 17.3, AU, p < 0.01) were observed among the 30 patients included in this study. Circulating levels of IGF-1 exhibited a 38% reduction (68.8 ± 43.6 to 42.4 ± 29.4, ng/mL, p = 0.01). Furthermore, pro-inflammatory cytokine (IFN-y) increased by 17% (4.83 ± 1.39 to 5.66 ± 1.61, pg./mL, p = 0.02) from day 1 to day 5.ConclusionsThese findings reveal substantial thickness and muscle composition alterations within 48 h post-admission, worsening over five days. Despite standard rehabilitation care, changes in IGF-1 and IFN-y levels suggest early declines in muscle growth stimulus and increased inflammation.© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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