IMPACT OF SARCOPENIA ON FUNCTIONAL RECOVERY IN ICU PATIENTS: PREVALENCE, CLINICAL OUTCOMES AND MANAGEMENT

Abstract

Background: Sarcopenia is increasingly recognised as a clinically important problem in critical care because immobility, systemic inflammation, inadequate nutritional intake, organ dysfunction, and mechanical ventilation can accelerate skeletal-muscle loss. Reduced muscle reserve may contribute to delayed mobilisation, prolonged dependence, and poorer recovery after intensive care. Bedside ultrasonography offers a practical method of assessing peripheral muscle status when conventional tests of strength and physical performance cannot be completed in unstable, sedated, or mechanically ventilated patients at admission.

Objective: To determine the prevalence of ultrasound-defined sarcopenia among critically ill adults and examine the relationships of quadriceps muscle thickness with age, sex, and place of residence.

Methods: This observational study included 93 critically ill adults admitted to an intensive care unit. Rectus femoris and vastus intermedius thicknesses were measured by bedside ultrasonography, and total quadriceps thickness was calculated from both measurements. Sarcopenia was classified using prespecified sex-specific rectus femoris thresholds. Data were analysed using descriptive statistics, the Mann–Whitney U test, Spearman's rank correlation, and multiple linear regression.

Results: The sample comprised 44 males (47.3%) and 49 females (52.7%), with a mean age of 32.71 ± 14.76 years; 78 participants (83.9%) were urban residents. No participant met the operational criteria for sarcopenia, yielding a prevalence of 0.0%. Mean rectus femoris, vastus intermedius, and total quadriceps thicknesses were 16.93 ± 5.00 mm, 13.28 ± 1.93 mm, and 30.22 ± 5.95 mm, respectively. Muscle thickness did not differ significantly by sex or residence. Age correlated inversely with vastus intermedius thickness (ρ = −0.249, p = 0.016) and independently predicted lower total quadriceps thickness (B = −0.098 mm/year, p = 0.018). The regression model explained 7.0% of the variance. Clinical-outcome associations could not be estimated because sarcopenia status was constant.

Conclusion: Ultrasound-defined sarcopenia was not identified in this relatively young ICU cohort. Increasing age predicted lower quadriceps thickness. Serial ultrasonography may detect emerging muscle loss and guide nutritional and rehabilitation strategies.

Keywords: Adult; Critical Illness; Intensive Care Units; Muscle, Skeletal; Quadriceps Muscle; Sarcopenia; Ultrasonography.