Evaluation of Bioelectrical Impedance Analysis in Critically Ill Patients: Results of a Multicenter Prospective Study

Kuchnia, Adam J.; Earthman, Carrie P.; Teigen, Levi; Cole, Abigail J.; Mourtzakis, Marina; Paris, Michael T.; Looijaard, Willem; Weijs, P.J.M.; Straaten, Heleen Oudemans-van; Beilman, Gregory J.; Day, Andrew G.; Leung, Roger; Compher, Charlene; Dhaliwal, Rupinder; Peterson, Sarah J.; Roosevelt, Hannah; Heyland, Daren K.

doi:10.1177/0148607116651063

Cited by 73 publications

(71 citation statements)

References 39 publications

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“…Thus, efforts are ongoing to identify clinically available measures of lean mass in hospitalized patients. 20,21 Furthermore, in this current report no information was available regarding sarcopenia, a condition expected to increase nutrition risk, especially in older critically ill patients. Finally, for the analysis of impact of adequacy of feeding, protein and energy intake were only reported for up to 12 days, yet mortality was reported up to day 60.…”

Section: Discussionmentioning

confidence: 88%

Greater Nutrient Intake Is Associated With Lower Mortality in Western and Eastern Critically Ill Patients With Low BMI: A Multicenter, Multinational Observational Study

Compher

Chittams

Sammarco

et al. 2018

J Parenter Enteral Nutr

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Section: Discussionmentioning

confidence: 88%

Greater Nutrient Intake Is Associated With Lower Mortality in Western and Eastern Critically Ill Patients With Low BMI: A Multicenter, Multinational Observational Study

Compher

Chittams

Sammarco

et al. 2018

J Parenter Enteral Nutr

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“…Serial ultrasound measurement of the rectus femoris cross‐sectional area has shown that muscle mass decreases continuously from ICU admission to almost one‐fifth of baseline at day 10 of an ICU stay . Low fat‐free mass as indicated by low phase angle or high impedance ratio obtained by bioelectrical impedance analysis measurement has also been shown to be associated with mortality and time‐discharge alive among the critically ill patients . However, the routine use of such body composition analysis techniques may be impractical in the mechanically ventilated critically ill population.…”

Section: Nutrition Assessmentmentioning

confidence: 99%

Determination of Nutrition Risk and Status in Critically Ill Patients: What Are Our Considerations?

Lee

Heyland

2018

Nut in Clin Prac

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The stress catabolism state predisposes critically ill patients to a high risk of malnutrition. This, coupled with inadequate or delayed nutrition provision, will lead to further deterioration of nutrition status. Preexisting malnutrition and iatrogenic underfeeding are associated with increased risk of adverse complications. Therefore, accurate detection of patients who are malnourished and/or with high nutrition risk is important for timely and optimal nutrition intervention. Various tools have been developed for nutrition screening and assessment for hospitalized patients, but not all are studied or validated in critically ill populations. In this review article, we consider the pathophysiology of malnutrition in critical illness and the currently available literature to develop recommendations for nutrition screening and assessment. We suggest the use of the (modified) Nutrition Risk in the Critically Ill (mNUTRIC) for nutrition risk screening and the subjective global assessment (SGA) together with other criteria relevant to the critically ill patients, such as gastrointestinal function, risk of aspiration, determination of sarcopenia and frailty, and risk of refeeding syndrome for nutrition assessment. Further research is needed to identify suitable nutrition monitoring indicators to determine the response to the provision of nutrition.

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“…PhA has also been suggested to be a prognostic marker for nutrition status in ICU patients . Accordingly, we showed that inadequate nutrition support in the SC group led to a lower PhA and, thus, to reduced nutrition status.…”

Section: Discussionmentioning

confidence: 57%

“…We selected a particular outcome parameter for the assessment of nutrition status: the PhA measured by BIA. PhA is one of the few nutrition‐related parameters with a proven prognostic effect for risk of malnutrition, survival in cancer patients, and severity of illness or mortality in ICU patients …”

Section: Discussionmentioning

confidence: 99%

Optimization of Nutrition Therapy with the Use of Calorimetry to Determine and Control Energy Needs in Mechanically Ventilated Critically Ill Patients: The ONCA Study, a Randomized, Prospective Pilot Study

Gonzalez‐Granda

Schollenberger

Haap

et al. 2018

J Parenter Enteral Nutr

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Background Adequate nutrition therapy in critically ill patients poses a challenge because of the variable energy and substrate needs. The objective was to investigate whether nutrition therapy involving indirect calorimetry (IC), instead of equations for assessment of energy needs, could improve the nutrition status of critically ill patients. Methods Forty mechanically ventilated patients were randomized into a group in which energy needs were controlled by calorimetry (IC group) and a group treated with a formula‐based approach reflecting standard care (SC group). The primary outcome was change in the phase angle (PhA), a bioelectrical impedance parameter related to nutrition status and prognosis. Results The mean IC‐based energy requirement was lower than the formula‐based estimate (21.1 ± 6.4 versus [vs] 25 kcal/kg/d, P < .01). The IC group reached 98% ± 8% of the energy goal, whereas the SC group reached only 79% ± 29% (P < 0.05), although mean intake was similar in both groups. The protein intake goal was better met in the IC group (91% ± 24%) than the SC group (73% ± 33%). The PhA of the IC group did not change during treatment, whereas that of the SC group tended to decrease by 0.36° ± 0.86° (P = .077). A shorter length of stay in intensive care was observed in the IC than in the SC group (13 ± 8 vs 24 ± 20 days, P < .05). Conclusion Intensified individual nutrition therapy involving IC appears to be useful for improving nutrition status in critically ill patients.

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Evaluation of Bioelectrical Impedance Analysis in Critically Ill Patients: Results of a Multicenter Prospective Study

Abstract: Our study highlights the potential utility of PA and IR as markers to identify patients with low muscularity who may benefit from early and rigorous intervention.

Cited by 73 publications

References 39 publications

Greater Nutrient Intake Is Associated With Lower Mortality in Western and Eastern Critically Ill Patients With Low BMI: A Multicenter, Multinational Observational Study

Greater Nutrient Intake Is Associated With Lower Mortality in Western and Eastern Critically Ill Patients With Low BMI: A Multicenter, Multinational Observational Study

Determination of Nutrition Risk and Status in Critically Ill Patients: What Are Our Considerations?

Optimization of Nutrition Therapy with the Use of Calorimetry to Determine and Control Energy Needs in Mechanically Ventilated Critically Ill Patients: The ONCA Study, a Randomized, Prospective Pilot Study

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