Reliability of ultrasonographic arm muscle thickness measurement by various levels of health care providers in ICU.

Purpose: Reliability of arm muscle thickness measurement using ultrasonography (USG) by operators of varied experience is unknown. Hence, we planned this study to determine the reliability of arm muscle thickness measured using USG by 5 observers with variable experience. Materials and method: This was a cross-sectional observational study which included critically ill patients with sepsis. Arm muscle thickness was measured in triplicate on Siemens ACUSON X300™ USG machine by each of 5 observers. Intra-class correlation coefficient (ICC) was computed to assess intra-observer and inter-observer variability of multiple observations.

Results: This study included 45 (30 - male) patients. Mean (±SD) age, APACHE and SAPS score of the participants were 54.95 (±15.97) years, 14.66 (±4.57) and 2.6 (±1.37), respectively. There were 135 observations by each observer. ICC (95%CI) for intra-observer reliability study for observer 1, 2, 3, 4, and 5 were 0.997 (0.995-0.998), 0.996 (0.993-0.998), 0.997 (0.996-0.998), 0.997 (0.994-0.998) and 0.998 (0.986-0.999), respectively. ICC (95%CI) for inter-observer reliability study for 1st, 2nd and 3rd reading were 0.963 (0.943-0.977), 0.992 (0.988-0.995) and 0.992 (0.988-0.995), respectively.

Conclusions: There was an excellent intra- and inter-observer agreement among 5 observers for measurement of arm muscle thickness using bedside USG among patients with sepsis.