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Nutrition in ICU Calorie Count
Nutritional status in critically ill patients can be difficult to assess. Anthropometric measurements (eg. skin fold thickness and mid-arm circumference) are commonly used to assess populations but are not particularly useful in individuals. Biochemical tests also have their limitations: albumin levels fall rapidly as part of the acute phase response and hemoglobin is affected by hemorrhage, haemolysis, transfusion and bone marrow suppression. Transferrin, prealbumin and lymphocyte counts can be useful however they are dependent on the patient being well hydrated. Body Mass Index (mass [kg] / height [m] 2) is a frequently used tool (with a BMI < 18.5 classed as underweight) and has been shown to be an independent predictor of mortality in seriously ill patients. Nevertheless it does not reflect the acute changes in nutritional status important in critical illness and is used most for the assessment of long term health risks of obesity. Probably the most useful measure of nutritional status is a targeted history and examination. One such method which is widely accepted is known as the Subjective Global Assessment which includes Weight change – both chronic (over 6 months) and acute (over 2 weeks ), Changes in food intake, Gastrointestinal symptoms – nausea, vomiting, diarrhea and anorexia, Functional impairment and is combined with a physical examination
About the Speaker
Dr. Adel Mohamed Yasin Al Sisi
MBBS, MD(Critical Care Medicine) , Ph. D (Critical Care Medicine)
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Dr. Adel Mohamed Yasin Al Sisi's Talks on Assimilate
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Nutritional status in critically ill patients can be difficult to assess. Anthropometric measurements (eg. skin fold thickness and mid-arm circumference) are commonly used to assess populations but are not particularly useful in individuals. Biochemical tests also have their limitations: albumin levels fall rapidly as part of the acute phase response and hemoglobin is affected by hemorrhage, haemolysis, transfusion and bone marrow suppression. Transferrin, prealbumin and lymphocyte counts can be useful however they are dependent on the patient being well hydrated. Body Mass Index (mass [kg] / height [m] 2) is a frequently used tool (with a BMI < 18.5 classed as underweight) and has been shown to be an independent predictor of mortality in seriously ill patients. Nevertheless it does not reflect the acute changes in nutritional status important in critical illness and is used most for the assessment of long term health risks of obesity. Probably the most useful measure of nutritional status is a targeted history and examination. One such method which is widely accepted is known as the Subjective Global Assessment which includes Weight change – both chronic (over 6 months) and acute (over 2 weeks ), Changes in food intake, Gastrointestinal symptoms – nausea, vomiting, diarrhea and anorexia, Functional impairment and is combined with a physical examination