Division of Intensive Care Medicine, Department of Anesthesiology and Reanimation, Muğla Sıtkı Koçman University, Mugla, Turkey
Division of Intensive Care Medicine, Department of Anesthesiology and Reanimation, Muğla Sıtkı Koçman University, Mugla, Turkey.
BMJ Open. 2023 Mar 30;13(3):e071796. doi: 10.1136/bmjopen-2023-071796.
Malnutrition is a clinical condition that is frequently seen in critically ill patients in the intensive care unit (ICU). Although there are many scoring systems and tools used to determine nutritional risk, those that can be used in critically ill patients in the ICU are very few. The scoring systems used are insufficient to identify ICU patients with malnutrition or at risk.Malnutrition is generally presented with a decrease in skeletal muscle mass and muscle strength. Therefore, in many recent studies, attention has been drawn to the relationship between nutritional status and loss of muscle mass.
A cohort study.
Forty-five patients hospitalised in an anaesthesia ICU in Turkey were included in the study.
Patients aged 18 years and older.
Demographic data of patients included in the study, and Nutritional Risk Screening 2002 (NRS-2002) and Modified Nutrition Risk in Critically ill (mNUTRIC) scores in the first 24 hours of ICU admission were noted. Rectus abdominis muscle (RAM) and rectus femoris muscle (RFM) thicknesses were measured by the same person (intensive care specialist) with ultrasonography (USG).
Finding a quantitative and practical evaluation method by determining the correlation of measurement of RAM and RFM thickness with USG with NRS-2002 and mNUTRIC score, which are scoring systems used to assess nutritional risk.
The performance of RAM and RFM thickness in determining nutritional status was evaluated by receiver operating characteristic (ROC) analysis. Area under the ROC curves were calculated as >0.7 for RFM and RAM measurements (p<0.05). Specificity and sensitivity percentages of RAM were found to be higher than RFM in determining nutritional status.
This study showed that RAM and RFM thickness measured by USG can be a reliable and easily applicable quantitative method that can be used to determine nutritional risk in the ICU.
营养不良是重症监护病房（ICU）中危重症患者经常出现的临床情况。虽然有许多评分系统和工具可用于确定营养风险，但ICU 中危重症患者可用的评分系统非常少。这些评分系统不足以识别 ICU 中有营养不良或有风险的患者。营养不良通常表现为骨骼肌量和肌肉力量减少。因此，在许多最近的研究中，人们关注营养状况与肌肉质量损失之间的关系。
队列研究。
土耳其一家麻醉 ICU 收治的 45 名患者纳入本研究。
年龄在 18 岁及以上的患者。
记录纳入研究患者的人口统计学数据，以及 ICU 入院后 24 小时内的营养风险筛查 2002 评分（NRS-2002）和改良危重患者营养风险指数（mNUTRIC）评分。同一人（重症监护专家）使用超声（USG）测量腹直肌（RAM）和股直肌（RFM）厚度。
通过确定 RAM 和 RFM 厚度与 NRS-2002 和 mNUTRIC 评分的 USG 测量值的相关性，找到一种定量且实用的评估方法，这些评分系统用于评估营养风险。
通过接受者操作特征（ROC）分析评估 RAM 和 RFM 厚度确定营养状况的性能。ROC 曲线下面积计算为 RFM 和 RAM 测量值 >0.7（p<0.05）。在确定营养状况方面，RAM 的特异性和敏感性百分比高于 RFM。
本研究表明，USG 测量的 RAM 和 RFM 厚度可以作为一种可靠且易于应用的定量方法，用于确定 ICU 中的营养风险。
