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危重症中去脂体重诊断评估的最新进展

Update on Lean Body Mass Diagnostic Assessment in Critical Illness.

作者信息

De Rosa Silvia, Umbrello Michele, Pelosi Paolo, Battaglini Denise

机构信息

Centre for Medical Sciences-CISMed, University of Trento, Via S. Maria Maddalena 1, 38122 Trento, Italy.

Anesthesia and Intensive Care, Santa Chiara Regional Hospital, APSS, 38123 Trento, Italy.

出版信息

Diagnostics (Basel). 2023 Feb 26;13(5):888. doi: 10.3390/diagnostics13050888.

Abstract

Acute critical illnesses can alter vital functions with profound biological, biochemical, metabolic, and functional modifications. Despite etiology, patient's nutritional status is pivotal to guide metabolic support. The assessment of nutritional status remains complex and not completely elucidated. Loss of lean body mass is a clear marker of malnutrition; however, the question of how to investigate it still remains unanswered. Several tools have been implemented to measure lean body mass, including a computed tomography scan, ultrasound, and bioelectrical impedance analysis, although such methods unfortunately require validation. A lack of uniform bedside measurement tools could impact the nutrition outcome. Metabolic assessment, nutritional status, and nutritional risk have a pivotal role in critical care. Therefore, knowledge about the methods used to assess lean body mass in critical illnesses is increasingly required. The aim of the present review is to update the scientific evidence regarding lean body mass diagnostic assessment in critical illness to provide the diagnostic key points for metabolic and nutritional support.

摘要

急性危重病可通过深刻的生物学、生物化学、代谢和功能改变来影响重要功能。无论病因如何,患者的营养状况对于指导代谢支持至关重要。营养状况的评估仍然复杂且尚未完全阐明。瘦体重的丢失是营养不良的明确标志;然而,如何对其进行评估的问题仍然没有答案。已经采用了多种工具来测量瘦体重,包括计算机断层扫描、超声和生物电阻抗分析,尽管遗憾的是这些方法需要验证。缺乏统一的床边测量工具可能会影响营养结局。代谢评估、营养状况和营养风险在危重症护理中起着关键作用。因此,对于危重病中评估瘦体重所用方法的了解需求日益增加。本综述的目的是更新关于危重病中瘦体重诊断评估的科学证据,以提供代谢和营养支持的诊断要点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5110/10000858/0776bffcabd8/diagnostics-13-00888-g001.jpg

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