Bedside nutrition evaluation and physical assessment techniques in critical illness

Abstract

Mid-arm muscle circumference, SGA fat loss, and SGA muscle wasting have each been found to be better predictors of poor outcome than BMI in ICU patients.Mid-arm muscle circumference, SGA fat loss, and SGA muscle wasting may be able to identify patients who are most likely to benefit from enhanced nutrition support.We need further research incorporating the use of these simple measures to evaluate their ability to accurately identify patients most likely to benefit from enhanced nutritional support.

Effect of early mobilization combined with early nutrition on acquired weakness in critically ill patients (EMAS): A dual-center, randomized controlled trial

“…Nutritional status was evaluated using the SGA [ 25 ], which is recommended by the American Society for Parenteral and Enteral Nutrition (ASPEN) and ESPEN [ 16 ] and can be used for critically ill patients [ 26 ].…”

Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition

“…[48,49]. Physical examination has been validated for assessment of nutrition status when implemented by trained personnel [50]. The subjective nature of physical examination can be limited by operator expertise and training as well as standardization of results [50].…”

Subjective Global Assessment Can Be Performed in Critically Ill Surgical Patients as a Predictor of Poor Clinical Outcomes

“…5 According to a recent review, fat loss and muscle wasting, both detected by the subjective global assessment (SGA), may be able to identify patients who are most likely to benefit from enhanced nutrition support; however, the authors point out that further research is needed to confirm these findings. 6 Emerging evidence suggests that undernourished patients according to the SGA have higher ICU readmission and mortality rates. [7][8][9] However, there is limited evidence on the applicability of SGA in critically ill patients, [7][8][9] despite its good performance in diagnosing undernutrition in clinical and surgical patients.…”

“…However, nutrition assessment methods usually used in hospitalized patients have limited applicability in the ICU. Indeed, a recent systematic review suggests that anthropometry, laboratory evaluation, and physical examination, methods commonly used for nutrition assessment of hospitalized patients, have little accuracy to diagnose undernutrition in critically ill patients, as highlighted by the American Society for Parenteral and Enteral Nutrition . According to a recent review, fat loss and muscle wasting, both detected by the subjective global assessment (SGA), may be able to identify patients who are most likely to benefit from enhanced nutrition support; however, the authors point out that further research is needed to confirm these findings …”