Skip to main content

An Introduction to Malnutrition in the Intensive Care Unit

  • Chapter
Nutrition Support for the Critically Ill

Part of the book series: Nutrition and Health ((NH))

  • 1630 Accesses

Abstract

Malnutrition is not a simple matter of balance in the critically ill. Many of the manifestations, such as alterations in protein levels and muscle mass, are strictly epiphenomena of disease. By the same token, the presence of these findings signals a significant increase in disease acuity and higher risk for medical/surgical complications and mortality. The understanding of modern concepts related to malnutrition will help the practitioner determine overall prognosis, as well as identifying more accurately the patient best suited for nutritional intervention.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fontes D, Generoso Sde V, Toulson Davisson correia MI. Subjective global assessment: a reliable nutritional assessment tool to predict outcomes in critically ill patients. Clin Nutr. 2014;33(2):291–5.

    Article  PubMed  Google Scholar 

  2. Reintam Blaser A, Poeze M, Malbrain ML, Björck M, Oudemans-van Straaten HM, Starkopf J, Gastro-Intestinal Failure Trial Group. Gastrointestinal symptoms during the first week of intensive care are associated with poor outcome: a prospective multicentre study. Intensive Care Med. 2013;39(5):899–909.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Tsai JR, Chang WT, Sheu CC, Wu YJ, Sheu YH, Liu PL, et al. Inadequate energy delivery during early critical illness correlates with increased risk of mortality in patients who survive at least seven days: a retrospective study. Clin Nutr. 2011;30(2):209–14.

    Article  PubMed  Google Scholar 

  4. Seres DS. Surrogate nutrition markers, malnutrition, and adequacy of nutrition support. Nutr Clin Pract. 2005;20(3):308–13.

    Article  PubMed  Google Scholar 

  5. Koretz RL. Death, morbidity and economics are the only end points for trials. Proc Nutr Soc. 2005;64(3):277–84.

    Article  PubMed  Google Scholar 

  6. Merriam-Webster On-line Dictionary. http://www.merriam-webster.com/dictionary/malnutrition.

  7. Murray ET, Hardy R, Hughes A, Wills A, Sattar N, Deanfield J, et al. Overweight across the life course and adipokines, inflammatory and endothelial markers at age 60–64 years: Evidence from the 1946 birth cohort. Int J Obes (Lond). 2015;39(6):1010–8.

    Article  CAS  Google Scholar 

  8. Lima KV, Lima RP, Goncalves MC, Faintuch J, Morais LC, Asciutti LS, et al. High frequency of serum chromium deficiency and association of chromium with triglyceride and cholesterol concentrations in patients awaiting bariatric surgery. Obes Surg. 2014;24(5):771–6.

    Article  PubMed  Google Scholar 

  9. Harkness L. The history of enteral nutrition therapy: from raw eggs and nasal tubes to purified amino acids and early postoperative jejunal delivery. J Am Diet Assoc. 2002;102(3):399–404.

    Article  PubMed  Google Scholar 

  10. Levenson SM, Hopkins BS, Waldron M, Canham JE, Seifter E. Early history of parenteral nutrition. Fed Proc. 1984;43(5):1391–406.

    CAS  PubMed  Google Scholar 

  11. Studley HO. Percentage of weight loss: a basic indicator of surgical risk in patients with chronic peptic ulcer. JAMA. 1936;106(6):458–60.

    Article  Google Scholar 

  12. Classification of infantile malnutrition. Lancet. 1970;2(7667):302–3.

    Google Scholar 

  13. Williams LDS. Prime Hospital Abruptly Stops Billing Medicare for Rare Ailment. 2012. http://ww2.kqed.org/news/2012/12/20/prime-hospital-abruptly-stops-billing-medicare-for-rare-ailment.

  14. Virbitsky S. University Hospitals Case Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor. 2014. https://oig.hhs.gov/oas/reports/region3/31300031.pdf.

  15. Seres DS, Resurreccion LB. Kwashiorkor: dysmetabolism versus malnutrition. Nutr Clin Pract. 2003;18(4):297–301.

    Article  PubMed  Google Scholar 

  16. Waterlow JC. Classification and definition of protein-calorie malnutrition. Br Med J. 1972;3(5826):566–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Dudrick SJ, Wilmore DW, Vars HM, Rhoads JE. Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery. 1968;64(1):134–42.

    CAS  PubMed  Google Scholar 

  18. Merriam-Webster On-line Dictionary. http://www.merriam-webster.com/dictionary/deficiency. Accessed 23 Mar 2015.

  19. Venkatram S, Chilimuri S, Adrish M, Salako A, Patel M, Diaz-Fuentes G. Vitamin D deficiency is associated with mortality in the medical intensive care unit. Crit Care. 2011;15(6):R292.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Amrein K, Schnedl C, Holl A, Riedl R, Christopher KB, Pachler C, et al. Effect of high-dose vitamin D3 on hospital length of stay in critically ill patients with vitamin D deficiency: the VITdAL-ICU randomized clinical trial. JAMA. 2014;312(15):1520–30.

    Article  PubMed  Google Scholar 

  21. Casaer MP, Langouche L, Coudyzer W, Vanbeckevoort D, De Dobbelaer B, Güiza FG, et al. Impact of early parenteral nutrition on muscle and adipose tissue compartments during critical illness. Crit Care Med. 2013;41(10):2298–309.

    Article  CAS  PubMed  Google Scholar 

  22. Galley HF, Webster NR. The immuno-inflammatory cascade. Br J Anaesth. 1996;77(1):11–6.

    Article  CAS  PubMed  Google Scholar 

  23. Mizock BA. Alterations in carbohydrate metabolism during stress: a review of the literature. Am J Med. 1995;98(1):75–84.

    Article  CAS  PubMed  Google Scholar 

  24. Andersen SK, Gjedsted J, Christiansen C, Tonnesen E. The roles of insulin and hyperglycemia in sepsis pathogenesis. J Leukoc Biol. 2004;75(3):413–21.

    Article  CAS  PubMed  Google Scholar 

  25. Wolfe RR, Herndon DN, Jahoor F, Miyoshi H, Wolfe M. Effect of severe burn injury on substrate cycling by glucose and fatty acids. N Engl J Med. 1987;317(7):403–8.

    Article  CAS  PubMed  Google Scholar 

  26. Janssen I. Influence of sarcopenia on the development of physical disability: the cardiovascular health study. J Am Geriatr Soc. 2006;54(1):56–62.

    Article  PubMed  Google Scholar 

  27. Ferrando AA, Lane HW, Stuart CA, Davis-Street J, Wolfe RR. Prolonged bed rest decreases skeletal muscle and whole body protein synthesis. Am J Physiol. 1996;270(4 Pt 1):E627–33.

    CAS  PubMed  Google Scholar 

  28. Salanova M, Gelfi C, Moriggi M, Vasso M, Viganò A, Minafra L, et al. Disuse deterioration of human skeletal muscle challenged by resistive exercise superimposed with vibration: evidence from structural and proteomic analysis. FASEB J. 2014;28(11):4748–63.

    Article  CAS  PubMed  Google Scholar 

  29. Casaer MP. Muscle weakness and nutrition therapy in ICU. Curr Opin Clin Nutr Metab Care. 2015;18(2):162–8.

    Article  CAS  PubMed  Google Scholar 

  30. White JV, Guenter P, Jensen G, Malone A, Schofield M, Academy Malnutrition Work Group, A.S.P.E.N. Malnutrition Task Force, A.S.P.E.N. Board of Directors. Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr. 2012;36(3):275–83.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David S. Seres MD, ScM, PNS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Seres, D.S. (2016). An Introduction to Malnutrition in the Intensive Care Unit. In: Seres, D., Van Way, III, C. (eds) Nutrition Support for the Critically Ill. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-21831-1_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-21831-1_1

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-21830-4

  • Online ISBN: 978-3-319-21831-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics