1
|
Kangalgil M, Küçük AO, Ulusoy H, Özçelik AÖ. Nutrition determinants of acute skeletal muscle loss in critically ill patients: A prospective observational cohort study. Nutr Clin Pract 2024; 39:579-588. [PMID: 37877164 DOI: 10.1002/ncp.11086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 09/02/2023] [Accepted: 09/24/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Skeletal muscle loss is associated with adverse outcomes in critically ill patients and risk factors of acute skeletal muscle loss are not well described. This study aims to determine the factors associated with acute skeletal muscle loss in critically ill patients. METHODS This prospective observational cohort study was conducted with patients who were expected to stay in the intensive care unit (ICU) for at least a week. Rectus femoris cross-sectional area (RFCSA) measurements were performed within 48 h of ICU admission and on study day 7. The percentage change in RFCSA and variables associated with this change were evaluated by univariate and multivariate regression analysis. RESULTS Over a 12-month period, 518 patients were assessed for eligibility and 44 critically ill patients with a mean age of 59.3 ± 10.9 years were enrolled; 52.3% of them were female. There were significant reductions in RFCSA (16.8 ± 16.5%; P < 0.001). The mean amounts of protein and energy consumed compared with those prescribed were 67.0 ± 28.8% and 71.5 ± 38.3%, respectively. Multivariate regression analysis revealed that frailty was independently associated with acute skeletal muscle loss after adjusting for confounding factors in our cohort of patients. CONCLUSION Frailty status before ICU admission is associated with acute skeletal muscle loss and may be important for identifying critically ill patients at high risk of muscle wasting.
Collapse
Affiliation(s)
- Melda Kangalgil
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
| | - Ahmet Oğuzhan Küçük
- Department of Pulmonary Diseases, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Hülya Ulusoy
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Ayşe Özfer Özçelik
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey
| |
Collapse
|
2
|
Díaz Chavarro BC, Romero-Saldaña M, Assis Reveiz JK, Molina-Recio G. Nutritional State, Immunological and Biochemical Parameters, and Mortality in the ICU: An Analytical Study. J Clin Med 2023; 12:4177. [PMID: 37445212 DOI: 10.3390/jcm12134177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 07/15/2023] Open
Abstract
Intensive care unit (ICU) hospitalization involves critically ill patients with multiple diseases and possible complications, including malnutrition, which increases hospital stay and mortality. Therefore, identifying the patient's prior nutritional state, following up during hospitalization, and implementing early intervention positively affect patient's vital situations at discharge. The objective of this study is to determine the nutritional state of patients admitted to an ICU in Cali (Colombia) in 2019 and its association with immunological and biochemical parameters and mortality observed during hospitalization. This was an observational, analytical, and retrospective study of patients admitted to an ICU in a clinic in Cali (Colombia) from 1 January to 31 March 2019. The association between their nutritional state and outcome variables such as hospital stay, immunological and biochemical function, and mortality was analyzed. Logistic regression was used to predict patients' vital status at hospital discharge. In terms of the nutritional level, low weight was observed in 17.5% patients, and overweight/obesity was observed in 53.5% of the population. Nutritional state was associated with leukocytosis. The patients with lymphocytosis had longer hospital stays than those with normal lymphocyte ranges. Age, blood leukocytes, and creatinine and potassium levels increased the risk of mortality. Lymphocyte values have been used as predictors of severity and hospitalization time. The scientific literature has also evidenced a higher leukocyte count in people with obesity, and such leukocytosis is associated with the risk of mortality. The results of blood and laboratory tests determining kidney function and blood electrolytes allow for the prediction of mortality risk in critically ill patients.
Collapse
Affiliation(s)
- Blanca Cecilia Díaz Chavarro
- Nursing Program, School of Health, Institute of Biomedical Research (IIB), Universidad Santiago de Cali, Santiago de Cali 760001, Colombia
- Doctoral Program in Biosciences and Agricultural and Food Sciences, University of Córdoba, 14014 Cordoba, Spain
| | - Manuel Romero-Saldaña
- Nursing, Pharmacology and Physiotherapy Department, University of Córdoba, 14004 Cordoba, Spain
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14014 Cordoba, Spain
| | - Jorge Karim Assis Reveiz
- Department of Research and Education, Clínica de Occidente SA, Santiago de Cali 760001, Colombia
| | - Guillermo Molina-Recio
- Nursing, Pharmacology and Physiotherapy Department, University of Córdoba, 14004 Cordoba, Spain
- Lifestyles, Innovation and Health (GA-16), Maimonides Biomedical Research Institute of Córdoba (IMIBIC), 14014 Cordoba, Spain
| |
Collapse
|
3
|
Javid Z, Shadnoush M, Khadem-Rezaiyan M, Mohammad Zadeh Honarvar N, Sedaghat A, Hashemian SM, Ardehali SH, Nematy M, Pournik O, Beigmohammadi MT, Safarian M, Moradi Moghaddam O, Khoshfetrat M, Zand F, Mohammad Alizadeh A, Kosari Monfared M, Mazaheri Eftekhar F, Mohamadi Narab M, Taheri AS, Babakhani K, Foroutan B, Jamialahmadi T, Jabbarzadeh Gangeh B, Meshkani M, Kimiaee F, Norouzy A. Nutritional adequacy in critically ill patients: Result of PNSI study. Clin Nutr 2020; 40:511-517. [PMID: 32711949 DOI: 10.1016/j.clnu.2020.05.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 05/05/2020] [Accepted: 05/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Critically ill patients are provided with the intensive care medicine to prevent further complications, including malnutrition, disease progression, and even death. This study was intended to assess nutritional support and its' efficacy in the Intensive Care Units (ICUs) of Iran. METHODS This cross-sectional study assessed 50 ICU's patients out of 25 hospitals in the 10 major regions of Iran's health system and was performed using the multistage cluster sampling design. The data were collected from patient's medical records, ICU nursing sheets, patients or their relatives from 2017 to 2018. Nutritional status was investigated by modified NUTRIC score and food frequency checklist. RESULTS This study included 1321 ICU patients with the mean age of 54.8 ± 19.97 years, mean mNUTRIC score of 3.4 ± 2.14, and malnutrition rate of 32.6%. The mean time of first feeding was the second day and most of patients (66%) received nutrition support, mainly through enteral (57.2%) or oral (37%) route during ICU stay. The patients received 59.2 ± 37.78 percent of required calorie and 55.5 ± 30.04 percent of required protein. Adequate intake of energy and protein was provided for 16.2% and 10.7% of the patients, respectively. The result of regression analysis showed that the odds ratio of mNUTRIC score was 0.85 (95% confidence interval [CI] = 0.74-0.98) and APACHE II was 0.92 (95%CI = 0.89-0.95) for the prediction of energy deficiency. Nutrition intake was significantly different from patient's nutritional requirements both in terms of energy (p < 0.001) and protein (p < 0.001). Also, mean mNUTRIC score varied notably (p = 0.011) with changing in energy intake, defined as underfeeding, adequate feeding, and overfeeding. CONCLUSION The present findings shown that, provided nutritional care for ICU patients is not adequate for their requirements and nutritional status.
Collapse
Affiliation(s)
- Zeinab Javid
- Student Research Committee, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Shadnoush
- Semnan University of Medical Sciences, Semnan, Iran; Department of Clinical Nutrition, Faculty of Nutrition & Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Khadem-Rezaiyan
- Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Niyaz Mohammad Zadeh Honarvar
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences & Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Sedaghat
- Faculty of Critical Care Medicine, Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mohammadreza Hashemian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Ardehali
- Department of Anesthesiology &Critical care, Shohadaye - Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Nematy
- Biochemistry and Nutrition Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Pournik
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Taghi Beigmohammadi
- Department of Anesthesiology and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Safarian
- Biochemistry and Nutrition Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Omid Moradi Moghaddam
- Trauma and Injury Research Center & Critical Care Department, Rasoul-e-Akram Complex Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Masoum Khoshfetrat
- Anesthesiology and Critical Care Department of Anesthesiology and Intensive Care Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farid Zand
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Afshin Mohammad Alizadeh
- Department of Bone Marrow Transplantation, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Maryam Mohamadi Narab
- Department of Nutrition, Sciences and Research Branch, Islamic Azad University, Tehran, Iran
| | - Arefe Sadat Taheri
- Kowsar Hospital, Semnan University of Medical Sciences and Health Services, Semnan, Iran
| | - Khatereh Babakhani
- Department of Nutrition, Sciences and Research Branch, Islamic Azad University, Tehran, Iran
| | - Behnam Foroutan
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Tannaz Jamialahmadi
- Student Research Committee, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mehrnoush Meshkani
- Department of Nutrition, Sciences and Research Branch, Islamic Azad University, Tehran, Iran
| | - Fahime Kimiaee
- Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Abdolreza Norouzy
- Biochemistry and Nutrition Department, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|