ArticleIntensive care medicine experimental2026
Early mechanical changes of limb muscle in septic shock assessed by dual-plane shear-wave elastography.
Article in Intensive care medicine experimental, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSeptic shock induces skeletal muscle wasting and neuromuscular dysfunction, contributing to ICU-acquired weakness (ICUAW) and poor recovery after critical illness. Conventional ultrasound primarily captures structural changes but provides limited insight into early muscle mechanical alterations or their relationships with clinical factors. Shear-wave elastography (SWE) enables non-invasive assessment of muscle stiffness, but its performance in critically ill patients remains poorly understood.
methodsIn this prospective study, adults with septic shock requiring invasive ventilation underwent daily muscle ultrasound during the first five ICU days. Rectus femoris muscle cross-sectional area, echogenicity and SWE-derived shear modulus (SM
resultsTwenty-seven patients (66.7% male, mean age 61 ± 12 years) were analysed (125 sessions, 4,971 images). Rectus femoris cross-sectional area declined from 3.90 cm² on Day 1 to 2.97 cm² by Day 5 (- 21%, p < 0.01), while echogenicity remained stable. Shear modulus (SM
conclusionsRapid muscle loss during early septic shock was accompanied by distinct, site- and direction-specific stiffness changes. Dual-plane SWE identified early mechanical changes, although these measures did not discriminate ICUAW status in this cohort. Associations with clinical variables suggest that SWE may help capture early physiological muscle changes in critical illness.
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