Fukushima R, Compher C W, Correia M I T D, Gonzalez M C, McKeever L, Nakamura K, Lee Z Y, Patel J J, Singer P, Stoppe C, Ayala J C, Barazzoni R, Berger M M, Cederholm T, Chittawatanarat K, Cotoia A, Lopez-Delgado J C, Earthman C P, Elke G, Hartl W, Hasan M S, Higashibeppu N, Jensen G L, Lambell K J, Lew C C H, Mechanick J I, Mourtzakis M, Nogales G C C, Oshima T, Peterson S J, Rice T W, Rosenfeld R, Sheean P, Silva F M, Tah P C, Uyar M
Department of Surgery Teikyo University School of Medicine, Department of Health and Dietetics, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan.
Biobehavioral Health Sciences Department and Nutrition Programs, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Clin Nutr. 2025 Jun;49:202-208. doi: 10.1016/j.clnu.2025.03.011. Epub 2025 Mar 31.
Patients with critical illness may present with disease-related malnutrition upon intensive care unit (ICU) admission. They are at risk of development and progression of malnutrition over the disease trajectory because of inflammation, dysregulated metabolism, and challenges with feeding.
The Global Leadership Initiative on Malnutrition (GLIM) convened a panel of 36 clinical nutrition experts to develop consensus-based guidance statements addressing the diagnosis of malnutrition during critical illness, using a modified Delphi approach with a requirement of ≥75% agreement.
CONCLUSION: Research using consistent etiologic and phenotypic variables offers great potential to assess the efficacy of nutrition interventions for critically ill patients with malnutrition. Assessment of these variables at during and beyond the ICU stay will clarify the trajectory of malnutrition and enable exploration of impactful treatment modalities at each juncture. GLIM offers a diagnostic approach that can be used to identify malnutrition in critically ill patients.
危重症患者在入住重症监护病房（ICU）时可能会出现与疾病相关的营养不良。由于炎症、代谢失调以及喂养困难，他们在疾病发展过程中存在营养不良发生和进展的风险。
全球营养不良领导倡议组织（GLIM）召集了一个由36名临床营养专家组成的小组，采用改良的德尔菲法，要求达成≥75%的共识，制定基于共识的指导声明，以解决危重症期间营养不良的诊断问题。
结论：使用一致的病因和表型变量进行研究，对于评估营养干预对重症营养不良患者的疗效具有巨大潜力。在ICU住院期间及出院后对这些变量进行评估，将明确营养不良的发展轨迹，并有助于在每个阶段探索有效的治疗方式。GLIM提供了一种可用于识别危重症患者营养不良的诊断方法。
