Body cell mass evaluation in critically ill patients: killing two birds with one stone

Abstract

Body cell mass (BCM) is the metabolically active cell mass involved in O2 consumption, CO2 production and energy expenditure. BCM measurement has been suggested as a tool for the evaluation of nutritional status. Since BCM is closely related to energy expenditure, it could also represent a good reference value for the calculation of nutrient needs. In a recent issue of Critical Care, Ismael and colleagues used bioelectrical impedance analysis parameters and anthropometric variables to evaluate BCM in patients with acute kidney injury, before and after a hemodialysis session. The results of this study suggest that BCM is relatively insensitive to major body fluid shifts, a well known factor interfering with nutritional evaluation/monitoring and energy need calculations in the ICU. Thus, BCM seems to be a more 'stable' nutritional variable, as it is apparently less influenced by non-nutritional factors. The results of this paper emphasize the need to identify biologically sound parameters for nutritional status evaluation and energy need calculation in critically ill patients; in this regard, BCM could fulfill these expectations.

High prevalence of burnout syndrome among intensivists of the city of Porto Alegre

“…This study found a high percentage of moderate-to-high burnout among intensivists, similar to intensivists from other countries (7,9,10) and to other Brazilian studies (12,13,15,16) showing that the percentages of considerable burnout were near to or even greater than 50%.…”

“…(5-8) Intensivists may have high burnout levels because of the stressful and demanding work associated with critical patient care. (6,9) …”

Burnout Syndrome Among Medical Practitioners Across India: A Questionnaire-Based Survey

“…There was an approximately 10% higher level of burnout and 17% higher level of dissatisfaction as compared to the general population in this particular study [4]. A high level of emotional exhaustion, depersonalization, and low personal accomplishments were reported among the nurses and respiratory therapists working in the intensive care unit (ICU) in the US [3]. Though the burnout in the medical field seems to be a universal phenomenon, it is not well documented in the literature.…”

“…Burnout has been studied among practicing doctors in many parts of the world including the USA [3-4], European countries [5-6], and Latin America [7], while very few studies are being reported from India [8-9]. In a study conducted in the USA in 2012, 7288 physicians completed a survey in which 45.8% of the physicians showed at least one symptom of burnout.…”

Burnout in the intensive care unit: Beware of turning to ash!

“…[12] In India, situations are very diverse and different depending upon the hospitals location, ownership, admission policies, etc.…”