HealthDay News — Children receiving invasive mechanical ventilation for ≥48 hours often experience muscle atrophy, especially in the diaphragm, according to a study published online Dec. 19 in PLOS ONE.

Ryan W. Johnson, MPH, from the Washington University School of Medicine in St. Louis, and colleagues conducted a prospective cohort study involving 34 critically ill children aged 1 week to 18 years with respiratory failure who were receiving invasive mechanical ventilation for ≥48 hours. Thirty of the participants completed 2 or more ultrasound assessments of muscle thickness for a median interval of 6 days.

In the entire cohort, researchers found an 11.1% decrease in diaphragm thickness between the first 2 assessments (2.2%/day); quadriceps thickness decreased by 8.62% (1.5%/day). There was no significant change in biceps or tibialis thickness. Forty-seven percent of the cohort experienced diaphragm atrophy (≥10% decrease in thickness), while 83 and 47% of patients experienced atrophy in at least one or at least two muscle groups, respectively. Increasing age and traumatic brain injury were correlated with greater muscle loss on multivariate linear regression.

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“It will be important for future multicenter studies to explore how skeletal muscle loss in critically ill kids impacts their recovery,” a coauthor said in a statement. “We know that adult patients with similarly weakened muscle tone take longer to wean from ventilators, have longer hospital stays, and face heightened mortality risk.”

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