Quantification and monitoring of lean body mass is an important component of nutrition assessment to determine nutrition status and muscle loss. The negative impact of reduced muscle mass and muscle function is increasingly evident across acute and chronic disease states but is particularly pronounced in patients with cancer. Ultrasound is emerging as a promising tool to directly measure skeletal muscle mass and quality. Unlike other ionizing imaging techniques, ultrasound can be used repeatedly at the bedside and may compliment nutritional risk assessment. This review aims to describe the current use of skeletal muscle ultrasound (SMUS) to measure muscle mass and quality in patients with acute and chronic clinical conditions and its ability to predict functional capacity, severity of malnutrition, hospital admission, and survival. Databases were searched from their inception to August 2021 for full-text articles in English. Relevant articles were included if SMUS was investigated in acute or chronic clinical contexts and correlated with a defined clinical outcome measure. Data were synthesized for narrative review due to heterogeneity between studies. This review analysed 37 studies (3100 patients), which met the inclusion criteria. Most studies (n = 22) were conducted in critical care. The clinical outcomes investigated included functional status at discharge (intensive care unit-acquired weakness), nutritional status, and length of stay. SMUS was also utilized in chronic conditions such as chronic obstructive pulmonary disease, chronic heart failure, and chronic renal failure to predict hospital readmission and disease severity. Only two studies investigated the use of SMUS in patients with cancer. Of the 37 studies, 28 (76%) found that SMUS (cross-sectional area, muscle thickness, and echointensity) showed significant associations with functional capacity, length of stay, readmission, and survival. There was significant heterogeneity in terms of ultrasound technique and outcome measurement across the included studies. This review highlights that SMUS continues to gain momentum as a potential tool for skeletal muscle assessment and predicting clinically important outcomes. Further work is required to standardize the technique in nutritionally vulnerable patients, such as those with cancer, before SMUS can be widely adopted as a bedside prognostic tool.

中文翻译：

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当前使用超声波测量骨骼肌及其预测临床结果的能力：系统评价


去脂体重的量化和监测是营养评估的重要组成部分，以确定营养状况和肌肉损失。肌肉质量和肌肉功能减少的负面影响在急性和慢性疾病状态下越来越明显，但在癌症患者中尤其明显。超声波正在成为一种有前景的直接测量骨骼肌质量和质量的工具。与其他电离成像技术不同，超声波可以在床边重复使用，并且可以补充营养风险评估。本综述旨在描述目前使用骨骼肌超声 (SMUS) 来测量急性和慢性临床疾病患者的肌肉质量和质量，及其预测功能能力、营养不良严重程度、入院和生存的能力。从数据库成立到 2021 年 8 月，我们对数据库进行了检索，以查找英文全文文章。如果在急性或慢性临床背景下研究 SMUS 并与明确的临床结果指标相关，则相关文章将被纳入。由于研究之间的异质性，数据被合成用于叙述性审查。本综述分析了 37 项研究（3100 名患者），符合纳入标准。大多数研究（ n = 22）是在重症监护中进行的。调查的临床结果包括出院时的功能状态（重症监护病房获得性虚弱）、营养状况和住院时间。 SMUS 还用于慢性阻塞性肺疾病、慢性心力衰竭和慢性肾衰竭等慢性疾病，以预测再入院和疾病严重程度。只有两项研究调查了 SMUS 在癌症患者中的使用。 在 37 项研究中，28 项 (76%) 发现 SMUS（横截面积、肌肉厚度和回声强度）与功能能力、住院时间、再入院和生存率显着相关。纳入的研究在超声技术和结果测量方面存在显着的异质性。本次综述强调，SMUS 作为骨骼肌评估和预测临床重要结果的潜在工具继续获得发展势头。在 SMUS 被广泛采用作为床边预后工具之前，需要进一步开展工作来标准化营养脆弱患者（例如癌症患者）的技术。