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Reliability of bedside ultrasound of limb and diaphragm muscle thickness in critically ill children
Author(s) -
Ng Kay W. P.,
DIETZ Alexander R.,
Johnson Ryan,
Shoykhet Michael,
Zaidman Craig M.
Publication year - 2019
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26327
Subject(s) - diaphragm (acoustics) , medicine , ultrasound , intraclass correlation , intra rater reliability , critically ill , inter rater reliability , atrophy , reliability (semiconductor) , anatomy , radiology , confidence interval , psychology , clinical psychology , rating scale , physics , developmental psychology , power (physics) , quantum mechanics , acoustics , loudspeaker , psychometrics
: We evaluated the reliability of measuring muscle thickness with ultrasound in limbs and diaphragms of critically ill children and determined the sensitivity of these measures to quantitate muscle atrophy over time. Methods : An expert and trained novice sonographers prospectively measured limb and diaphragm muscle thickness in 33 critically ill children. Results : Expert and novice intrarater and interrater reliability were similar. Intraclass correlations (ICC) and coefficients of variation (CoV) were better in limbs (ICC > 0.9; CoV 3.57%–5.40%) than in diaphragm (ICC > 0.8; CoV novice 11.88%, expert, 12.28%). Mean relative difference in all muscles was small (1%‐8%). Limits of agreement of the relative difference were smaller in limb (<13%–18%) than in diaphragm (<38%) muscles. Discussion : Muscle thickness is reliably measured with ultrasound by trained examiners in critically ill children. Our approach detects atrophy >13% in limb and >38% in diaphragm muscles. The smaller detectable change in limb muscles is likely due to their greater thickness. Muscle Nerve 59 :88–94, 2019