Implementação da espessura do músculo adutor do polegar na avaliação nutricional de pacientes críticos em um hospital de alta complexidade

Nutritional assessment of critically ill patients presents a challenge due to metabolic alterations, clinical instability, and limitations of conventional anthropometric methods. In this context, the thickness of the adductor pollicis muscle (APMT) shows potential as a complementary tool. This study aimed to evaluate the feasibility of incorporating APMT into the institutional protocol for nutritional assessment of critically ill patients. This is a descriptive, qualitative-quantitative implementation study, developed in a high-complexity hospital, involving a narrative literature review, updating of the institutional protocol, inclusion of the measurement in the TASY computerized system, professional training, and application of a structured questionnaire to assess participants' perception. The review included 44 studies published between 2017 and 2025. Implementation was directed to general and coronary intensive care units I and II, without collection or analysis of patients' clinical data. Eight professionals participated, all without prior experience with the technique. Regarding ease of execution, 75% considered the measurement easy or very easy, while 25% reported moderate difficulty. All participants acknowledged its contribution to nutritional assessment. Half of the participants considered that EMAP could assist in the early identification of muscle loss, while the other half indicated a partial contribution. Reliability was considered satisfactory by 50% and partial by the remainder. The main limitations identified were edema, anasarca, limb immobilization, bandaging, and the absence of consolidated reference values. It is concluded that the incorporation of EMAP presented operational feasibility and good initial acceptability, although its use requires technical standardization, professional training, and careful interpretation, associated with other nutritional assessment parameters.