Assessment of Nutritional Status in the Critically Ill

Abstract

How to cite this article: Narayan SK, Gudivada KK, Krishna B. Assessment of Nutritional Status in the Critically Ill. Indian J Crit Care Med 2020;24(Suppl 4):S152–S156.

A longitudinal study to determine if all critically ill patients should be considered at nutrition risk or is there a highly accurate screening tool to be adopted?

“…Detailed information on who responded to the nutrition anamnesis is not always reported. Narayan et al suggest that an ideal nutrition screening tool for ICU settings might assess dietary, physical, anthropometric, psychological, social, and clinical factors, and each variable assessed should be justified with an evidence‐based risk factor or outcome 7 . As seen in the current study, no evaluated screening tool has been able to predict a wide variety of worse outcomes in critically ill patients although most of them fulfill the majority of these criteria.…”

“…Narayan et al suggest that an ideal nutrition screening tool for ICU settings might assess dietary, physical, anthropometric, psychological, social, and clinical factors, and each variable assessed should be justified with an evidence-based risk factor or outcome. 7 As seen in the current study, no evaluated screening tool has been able to predict a wide variety of worse outcomes in critically ill patients although most of them fulfill the majority of these criteria. Considering our results and the challenge of accessing the food intake and the body weight/height of critically ill patients, as well as the relevance of the severity of the disease in their prognosis, a new tool should be developed combining any easy and simple nutrition indicator and the disease severity markers.…”

“…3 Following recommendations from prominent national and international societies, [4][5][6] the first step in the nutrition care process requires using a validated screening tool, with adequate validity, reliability, sensitivity, specificity, and positive predictive value (PPV) for identifying patients at high nutrition risk. 7 Heyland et al proposed that the nutrition risk of critically ill patients should not be seen as the risk of malnutrition, given that the inflammatory response to stress and the consequent protein catabolism affect all critically ill patients. The authors suggest that it be evaluated as the risk of the patient presenting complications or worse outcomes that could be prevented with adequate nutrition therapy.…”

Subclinical Kwashiorkor in Adults

“…[ 59 60 61 ] Other than these, critically ill patients being managed in intensive care units (ICUs) or those hospitalized for a prolonged period are more likely to develop PEU. [ 62 ] Secondary endocrine causes such as endogenous Cushing’s syndrome, chronic adrenal insufficiency, chronic steroid use, uncontrolled diabetes, hyperthyroidism and hypogonadism should be ruled out in patients where no other obvious cause can be identified. [ 48 ]…”

Nutritional support in Intensive Care Units Time for personalization?

“…17 Analiza slike kompjuteriziranom tomografijom u području abdomena (L3,) mjeri površinu presjek miši ća i određuje kvalitetu (gustoću) mišića. 18 Spektroskopskom segmentalnom bioelektričnom impedancom mjeri se masa bez masti (kg) i fazni kut (50 kHz). Ukupna tjelesna voda, postotak tjelesne masti i masa bez masti procjenjuju se pomoću regresij skih jednadžbi.…”