Nutrition Support for Critically Ill Patients With Cancer

Abstract

Oncology patients often experience the classic signs of malnutrition-weight loss as well as fat and muscle wasting, which have been associated with poor tolerance to treatment and increased morbidity and mortality. Nutrition status may be an important factor in determining tolerance to treatment and outcomes associated with it. Thus, identification of those with preexisting malnutrition or who are at risk for developing malnutrition is crucial not only at time of cancer diagnosis but also throughout the treatment course so that nutrition interventions may be implemented to prevent development or worsening of malnutrition in this high-risk population. These patients often have extremely complicated hospital courses due to the aggressive nature of the disease and treatment, leading to intensive care unit admission and periods of critical illness. Critical illness is associated with catabolism, extreme stress on the body, and a state of systemic inflammation. During critical illness, it is important to provide adequate nutrition to prevent further break down of lean muscle mass and oxidative cellular injury and to regulate favorable immune responses. The purpose of this review is to discuss the importance of nutrition screening and assessment for the critically ill patient with cancer; to appropriately identify those at risk for, or who have developed, malnutrition; and to provide appropriate interventions to optimize nutrition status. This review also discusses the complications and difficulties associated with feeding this patient population and offers nutrition support recommendations.

<p>Predictive Values of Preoperative Prognostic Nutritional Index and Systemic Immune-Inflammation Index for Long-Term Survival in High-Risk Non-Muscle-Invasive Bladder Cancer Patients: A Single-Centre Retrospective Study</p>

“…23 Malnutrition, reflected by hypoalbuminemia, is associated with increased morbidity and mortality. 24 Several studies have shown that malnutrition also interferes with the patient’s response to cancer treatment, 25 and malnutrition is related to immunosuppression, which provides a favourable microenvironment for tumour recurrence. 26 , 27 The association between inflammation and tumours was first noticed by Virchow in 1863.…”

Parenteral nutrition effects of Omega-3 fatty acids on C-reactive protein, high-density lipoprotein, lymphocyte characteristics and the treatment of critically ill patients

“…Due to the consumption and invasion of tumour diseases and the injuries brought by various treatment procedures, cancer patients often have a process of fat and muscle consumption and weight loss, resulting in malnutrition, low immunity, poor tolerance to treatment and high mortality. (5,6) Clinical studies have preliminarily shown that omega-3 fatty acids can improve the prognosis of critically ill patients (7,8). In addition, the fatty acids can also improve the inflammatory responses and nutritional status of malignant tumour patients, enhance their immune function and the sensitivity and tolerance to tumour radiotherapy and chemotherapy, and inhibit tumour growth.…”

Risk factors for malnutrition among hospitalized gastroenterological patients

“…It is known that numerous metabolic disorders and negative energy balance in malignancies lead to malnutrition and cachexia. 35,36 According to the results of other studies, the prevalence of hospital malnutrition is high in oncology patients. 22,37,38 Pirlih pointed to malignancy as one of three independent predictors of malnutrition on hospital admission.…”