Muscle dysfunction in intensive care units is associated with significant morbidity and mortality. During septic shock, there is an increased catabolism and systemic inflammation resulting in quantitative and qualitative muscle impairment. In the intensive care setting, quantitative and qualitative assessment of muscle function is challenging due to critical care environments (general anesthesia, altered consciousness, etc.). CT scan measurement at the 3rd lumbar level has been proposed to evaluate muscle function. Recent retrospective studies have highlighted increased mortality among patients with muscle mass impairment and/or decreased muscle density.
To date, no prospective study has assessed the prognostic value of CT scan measurements of muscle function upon admission to intensive care units for patients treated for septic shock. That is the aim of this project.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
196
Correlation between muscle L3 CT scan muscle derived parameters of muscle function upon intensive care unit admission and 3 months mortality after ICU discharge for patients admitted for septic shock
Hospices Civils de Lyon
Lyon, France
NOT_YET_RECRUITINGAP HM, Hôpital La Timone
Marseille, France
NOT_YET_RECRUITINGClinique Mutualiste
Saint-Etienne, France
NOT_YET_RECRUITINGCentre Hospitalier Universitaire de Saint-Etienne
Saint-Etienne, France
RECRUITINGvital status
alive or dead
Time frame: 90 days
Total muscle mass measured at L3 (cm²/m² )
Total muscle mass measured at L3 by CT scan, normalized by patient height (Skeletal Muscle Index), in cm²/m² upon admission to the ICU (Correlation between three L3 CT scan parameters of muscle function upon admission to the intensive care unit and the risk of mortality at 3 months after ICU discharge in septic shock patients).
Time frame: at inclusion
Total muscle density measured at L3 ( Hounsfield Unit)
\- Total muscle density measured at L3 by CT scan (Skeletal Muscle Density) in HU upon admission to the ICU (Correlation between three L3 CT scan parameters of muscle function upon admission to the intensive care unit and the risk of mortality at 3 months after ICU discharge in septic shock patients).
Time frame: at inclusion
Total fat excretion fraction measured at L3 (%)
Total fat excretion fraction measured at L3 (Fat Fraction) by CT scan upon admission to the ICU (Correlation between three L3 CT scan parameters of muscle function upon admission to the intensive care unit and the risk of mortality at 3 months after ICU discharge in septic shock patients).
Time frame: at inclusion
SOFA (Sequential Organ Failure Assessment) severity score
minimum=0, maximum=3 (Worse score)
Time frame: at inclusion, 10 days.
Kinetics of changes in muscle assessment
To assess the kinetics of changes in muscle scan parameters and muscle function.
Time frame: Day 1, 10, 90
Total fat excretion fraction measured at L3 (%)
Evolution of the total fat excretion fraction measured at L3 (Fat Fraction) by CT scan at inclusion, 10 days and 90 days.
Time frame: at inclusion, 10 days, 90 days
Total muscle density measured at L3 ( Hounsfield Unit)
Evolution of total muscle density measured at L3 by CT scan (Skeletal Muscle Density) in HU upon inclusion, 10 days, 90 days
Time frame: at inclusion, 10 days, 90 days
Total muscle mass measured at L3 (cm²/m² )
Evolution of the total muscle mass measured at L3 by CT scan, normalized by patient height (Skeletal Muscle Index), in cm²/m² upon inclusion, 10 days, 90 days.
Time frame: at inclusion, 10 days, 90 days
MRC score (Medical Research Council)
Minimum=0 (worse score), Maximum=5
Time frame: at discharge from intensive care, 90 days
Handgrip test (Kg)
Time frame: at discharge from intensive care, 90 days
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