Measuring Body Composition in Intensive Care Patients

Hill, Graham L.; Monk, David; Plank, Lindsay D.

doi:10.1007/978-3-642-85011-0_1

Cited by 15 publications

(16 citation statements)

References 31 publications

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“…We observed a reduction in the body weight of critically ill patients between test occasions, which was correlated with a reduction in tetra‐polar estimated ECF. This is consistent with other observations of critically ill patients, which demonstrate that fluctuations in body weight can mostly be attributed to changes in body water, whereas there is a slow, steady depletion of total body and skeletal muscle protein 1 , 8 , 29 …”

Section: Discussionsupporting

confidence: 93%

“…For instance, the anthropometric assessment of body weight can be arduous in critically ill patients because of the limitations of equipment accessibility, patients' fluctuating physiological stability, and the need to implement a standardized procedure for sequential measurements. Still, the gold standards of BCA depend on the model used and the compartments measured 8 . There are equipment, expertise, and practical limitations to BCA during critical illness, combined with patient safety and exposure concerns related to the isotope dilution methods, techniques involving electromagnetic radiation, and other forms of imaging.…”

mentioning

confidence: 99%

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Body Composition Analysis in Critically Ill Survivors

Baldwin

Paratz

Bersten

2012

J Parenter Enteral Nutr

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

Body Composition Analysis in Critically Ill Survivors

Baldwin

Paratz

Bersten

2012

J Parenter Enteral Nutr

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“…10 The body was scanned twice with a resultant precision of 2.5% and an accuracy compared with chemical analysis of within 4% (based on anthropomorphic phantoms). 11 Total Figure 1. Study design.…”

Section: Total Body Nitrogenmentioning

confidence: 99%

Sequential Changes in the Metabolic Response to Orthotopic Liver Transplantation During the First Year After Surgery

Plank

Metzger²,

McCall³

et al. 2001

Annals of Surgery

109

100

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ObjectiveTo quantify the sequential changes in the metabolic response occurring in patients with end-stage liver disease after orthotopic liver transplantation (OLT). Summary Background DataDetailed quantification of the changes in energy expenditure, body composition, and physiologic function that occur in patients after OLT has not been performed. Understanding these changes is essential for the optimal management of these patients. MethodsFourteen patients who underwent OLT for end-stage liver disease had measurements of resting energy expenditure, body composition, and physiologic function immediately before surgery and 5, 10,15,30, 90, 180, and 360 days later. ResultsResting energy expenditure was significantly elevated after surgery (24% above predicted), peaking around day 10 after OLT, when it averaged 42% above predicted. A significant degree of hypermetabolism was still present at 6 months, but at 12 months measured resting energy expenditure was close to predicted values. Before surgery, measured total body protein was 82% of estimated preillness total body protein. During the first 10 days after OLT, a further 1.0 kg (10%) of total body protein was lost, mostly from skeletal muscle. Only 54% of this loss was restored by 12 months. Significant overhydration of the fat-free body was seen before OLT, and it was still present 12 months later. Although significant losses of body fat and bone mineral occurred during the early postoperative period, only body fat stores were restored at 12 months. Both subjective fatigue score and voluntary hand grip strength improved rapidly after OLT to exceed preoperative levels at 3 months. At 12 months grip strength was close to values predicted for these patients when well. Respiratory muscle strength improved less markedly and was significantly lower than predicted normal levels at 12 months. ConclusionsBefore surgery, these patients were significantly protein-depleted, overhydrated, and hypermetabolic. After surgery, the period of hypermetabolism was prolonged, restoration of body protein stores was gradual and incomplete, and respiratory muscle strength failed to reach expected normal values. Our measurements indicate that OLT does not normalize body composition and function and imply that a continuing metabolic stress persists for at least 12 months after surgery.Orthotopic liver transplantation (OLT) is the accepted treatment for patients with end-stage liver disease. The surgical death rate for this procedure has decreased progressively during the past decade as a result of improvements in surgical technique, anesthesia, and postoperative care. Overall 1-year graft and patient survival rates of 80% to 90% can now be expected. For elective patients with nonrecurrent disease, the 1-year survival rate exceeds 90%.

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“…17 Patients underwent sequential measurements of body weight, total body fat, total body protein, total body water, and ECW as soon as they were hemodynamically stable (defined by no continuing requirement for resuscitation fluids or escalation of inotropic day study period, showing that significant losses in body weight, protein, water, and ECW occurred in each group during the study period. In the young group, most of the loss of ECW occurred in the first 5 days of the study, while, in the elderly group, significant losses of ECW only occurred in the 10-to 21-day period.…”

Section: Body Composition Studiesmentioning

confidence: 99%

“…Measurement of total body fat was carried out by dual-energy x-ray absorptiometry (model DPX+, version 3.6y, Lunar Radiation Corp, Madison, Wis). 17 The fat-free body mass was calculated from the difference between measured body weight and total body fat. Total body protein was measured by prompt gamma in vivo neutron activation analysis whereby total body nitrogen is obtained independently of total body hydrogen.…”

Section: Continuing Sepsis and Renal Functionmentioning

confidence: 99%