Ultrasonography evaluation of rectus femoris and anterior tibialis muscles for nutritional assessment in cirrhotic patients undergoing major abdominal surgery

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Abstract

Objectives
This prospective cohort study evaluate the reliability of ultrasonography in nutritional assessment for patients with liver cirrhosis undergoing major abdominal surgery by follow up the quantitative and morphological changes of rectus femoris (RF) and anterior tibialis (AT) muscles.
Methods
Seventy-two adults cirrhotic patients, subjective global assessment grade (SGA A&B) scheduled for major abdominal surgery were assessed preoperative and postoperative days (POD) 1, 3, 5 and 7 in ICU using anthropometric measurements, laboratory investigations, ultrasonography for cross-sectional area (CSA), anteroposterior (AP) and laterolateral (LL) diameters of (RF) and (AT) muscles and record hospital stay time.
Results
We reported significant decrease in all measures of RF and AT muscle masses (CSA, AP and LL) diam. started early after ICU admission up to 7 days. All statistically significant decreased compared to POD0 and 1 (p = 0.000). There was 0.56%, 2.05%, 3.28% and 3.67% loss of CSA of RF at POD1, POD3, POD5 and POD7 correspondingly. As well as there was 0.23%, 1.03%, 1.84%, 2.49% loss of CSA of AT in POD1, POD3, POD5 and POD7 correspondingly. Echogenicity score of both muscles were significant increase in POD3, 5 and 7 compared to POD0 (p = 0.000).
Conclusion
We used the ultrasound easily for skeletal muscle assessments as well as it helped us to detect the qualitative changes of these muscles and subsequently it can be used as a nutritional assessment tool in LC patients. Muscle US is an emerging tool can used in nutritional guided protocol on malnourished hepatic patient in the future.

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Egyptian Journal of Anaesthesia
Volume 36, Issue 1
January 2020
Pages 227-233

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