Nutritional state assessed by ultrasonography, but not by bioelectric impedance, predicts 28-day mortality in critically ill patients. Prospective cohort study

Passos, Liliane Barbosa da Silva; Macedo, Thiago Andrade; De-Souza, Daurea Abadia

doi:10.1016/j.clnu.2021.10.015

Cited by 19 publications

(18 citation statements)

References 42 publications

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“…Our results showed that ICU patients had lower PA measurements than healthy individuals, with the mean PA varied among the included studies (from approximately 3.7 • to 5.9 • ) (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(28)(29)(30)(31)(32)(33)(34). The variation was related to different patient characteristics, such as ethnicity, gender ratio, disease type, age, etc.…”

Section: Discussionmentioning

confidence: 73%

“…Our literature search yielded 442 potentially eligible articles through database searching. Further screening of 28 full texts identified 20 studies with 3,770 patients that fulfilled our inclusion criteria and were included in the final analysis (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(27)(28)(29)(30)(31)(32)(33)(34)(35). Figure 1 shows the search strategy flowchart.…”

Section: Trial Identification and Characteristicsmentioning

confidence: 99%

“…Flow diagram for the identification of relevant studies. low and normal PA groups (13,18,20,21,27,(29)(30)(31)(32)(33)(34). Among these patients, 939 had low PA, and 259 died (27.6%) compared to 231 deaths (14.0%) in 1,655 normal PA patients.…”

Section: Trial Identification and Characteristicsmentioning

confidence: 99%

“…The pooled data showed that PA (as a continuous variable) had a significant prognostic role on patients' survival (7 studies, N = 2,234; OR = 0.64; 95% CI 0.52-0.79; P < 0.00001, I 2 = 73%, randomeffects model, Figure 4; 14,18,23,27,30,32,34). Similarly, belonging to the reduced PA group (as a categorical variable) was a significant risk factor for mortality (8 studies, N = 1,464; OR = 2.42; 95% CI 1.76-3.34; P < 0.00001, I 2 = 0%, fixed-effects model, Figure 5; 19,20,27,[30][31][32][33][34]. Table 4 shows the detailed information of subgroup analyses by categories or continuous 10.3389/fmed.2022.1059747 variables, and the significant association between PA and allcause mortality was also confirmed in all subgroups except the long-term follow-up group with only two studies.…”

Section: Trial Identification and Characteristicsmentioning

confidence: 99%

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Prognostic role of bioelectrical impedance phase angle for critically ill patients: A systemic review and meta-analysis

Zheng

Zhao²,

Yao³

et al. 2023

Front. Med.

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ObjectiveBioelectrical impedance-derived phase angle (PA) has exhibited good prognostic values in several non-critical illnesses. However, its predictive value for critically ill patients remains unclear. Thus, we aimed to perform a systematic review and meta-analysis to investigate the relationship between PA and survival in such a patient population.Materials and methodsWe searched for relevant studies in PubMed, Embase, and the Cochrane database up to Jan 20, 2022. Meta-analyses were performed to determine the association between the baseline PA after admission with survival. We further conducted subgroup analyses and sensitivity analyses to explore the sources of heterogeneity.ResultsWe included 20 studies with 3,770 patients. Patients with low PA were associated with a significantly higher mortality risk than those with normal PA (OR 2.45, 95% CI 1.97–3.05, P < 0.00001). Compared to survivors, non-survivors had lower PA values (MD 0.82°, 95% CI 0.66–0.98; P < 0.00001). Similar results were also found when pooling studies reported regression analyses of PA as continuous (OR = 0.64; 95% CI 0.52–0.79, P < 0.00001) or categorical variable (OR = 2.42; 95% CI 1.76–3.34; P < 0.00001). These results were further confirmed in subgroup analyses and sensitivity analyses.ConclusionOur results indicated that PA may be an important prognostic factor of survival in critically ill patients and can nicely complement the deficiencies of other severity scoring systems in the ICU setting.

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Section: Discussionmentioning

confidence: 73%

Section: Trial Identification and Characteristicsmentioning

confidence: 99%

Section: Trial Identification and Characteristicsmentioning

confidence: 99%

Section: Trial Identification and Characteristicsmentioning

confidence: 99%

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Prognostic role of bioelectrical impedance phase angle for critically ill patients: A systemic review and meta-analysis

Zheng

Zhao²,

Yao³

et al. 2023

Front. Med.

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“…A recent investigation showed how in critically ill patients BIA-assessed body composition is significantly modified after one week of ICU stay, and how BIA may be useful to define the hydration state, while it does not seem to track muscle mass [ 46 ]. Moreover, in critically ill patients, the nutritional status assessed by ultrasonography, but not by BIA, was shown to predict 28-day mortality [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Nutrition support for critically ill patients during the COVID-19 pandemic: the Italian SIAARTI survey

Tetamo

Fittipaldi

Buono

et al. 2022

J Anesth Analg Crit Care

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Background Critically ill, COVID-19 patients are characterized by a hypermetabolic state and a reduced food intake and are at high risk of malnutrition and lean body mass loss. An appropriate metabolic-nutritional intervention aims to reduce complications and improve the clinical outcomes. We conducted a cross-sectional, multicenter, observational, nationwide online survey involving Italian Intensivists to assess the nutritional practices in critically ill patients with COVID-19. Results A group of experts in nutrition of the Italian Society of Anaesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) developed a 24-item questionnaire; the 9000 members of the Society were invited to participate through emails and social networks. Data was collected from June 1 to August 1, 2021. A total of 545 responses were collected: 56% in northern, 25% in central, and 20% in southern Italy. Artificial nutrition support is directly handled by intensivists in > 90 of the cases; the nutritional status is assessed as suggested by the guidelines in more than 70% of the cases, and a form of nutrition support is started within the first 48 h from ICU admission by > 90% of the respondents. Nutritional targets are reached in 4–7 days in > 75% of the cases, mainly by the enteral route. Indirect calorimetry, muscle ultrasound, and bioimpedance analysis are used by a limited part of the interviewees. Only about a half of the respondents reported the nutritional issues in the ICU discharge summary. Conclusions This survey among Italian Intensivists during the COVID-19 epidemic showed how the beginning, progression, and route of nutritional support adhere to international recommendations, while recommendations on the tools to set the target and monitor the efficacy of the metabolic support are less followed.

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Monitoring of Muscle Mass in Critically Ill Patients

Umbrello,

Formenti,

Brogi

et al. 2024

Nutrition, Metabolism and Kidney Support

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Nutritional state assessed by ultrasonography, but not by bioelectric impedance, predicts 28-day mortality in critically ill patients. Prospective cohort study

Cited by 19 publications

References 42 publications

Prognostic role of bioelectrical impedance phase angle for critically ill patients: A systemic review and meta-analysis

Prognostic role of bioelectrical impedance phase angle for critically ill patients: A systemic review and meta-analysis

Nutrition support for critically ill patients during the COVID-19 pandemic: the Italian SIAARTI survey

Monitoring of Muscle Mass in Critically Ill Patients

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