In children receiving invasive mechanical ventilation, diaphragm and other skeletal muscle atrophy is common and rapid, according to research published in PLoS One.
The single-centre, prospective cohort study included 34 children receiving invasive mechanical ventilation for at least 48 hours. Serial bedside ultrasound was carried out to assess the thickness of the diaphragm, biceps brachii/brachialis, quadriceps femoris and tibialis anterior. Serial electrical impedance myography (EIM) was assessed in children aged over one year.
Thirty of the 34 participants completed at least two ultrasound assessments with a median interval of six days.
In the entire cohort, diaphragm thickness decreased 11.1 per cent between the first two assessments, equating to 2.2 per cent per day. Quadriceps thickness decreased 8.62 per cent or 1.5 per cent per day. Biceps and tibialis thicknesses did not change.
Among the entire cohort, 47 per cent experienced diaphragm atrophy (≥10% decrease in thickness). Eighty-three per cent experienced atrophy in at least one muscle group, and 47 per cent experienced atrophy in at least two muscle groups.
On multivariate linear regression, increasing age and traumatic brain injury (TBI) were associated with greater muscle loss.