The following is a summary of “Bioimpedance-assessed muscle wasting and its relation to nutritional intake during the first week of ICU: a pre-planned secondary analysis of Nutriti Study,” published in the February 2024 issue of Critical Care by Deana al.
Researchers conducted a retrospective study to assess muscle mass (MM) decline using Bioimpedance analysis (BIA) in ICU patients during the initial 7 days, additionally exploring potential correlations between muscle loss and calorie/protein intake deficiencies.
They evaluated patients expected to stay in the ICU for at least 72 hours and required artificial nutritional support for inclusion in the study. Bioimpedance analysis (BIA) was conducted to assess muscle mass and phase angle (PA) upon ICU admission and after 7 days. Caloric and protein debt were calculated considering nutritional macronutrient delivery variance from ideal targets. The potential correlation between caloric and protein debt and changes in MM and PA was analyzed.
The results showed 72 patients (September 1, 2019, and October 30, 2019, as well as from August 1, 2021, to October 30, 2021), with a median age of 68 years [range 59–77], with primarily male admissions (72%) due to respiratory failure (25%) and requiring invasive mechanical ventilation for a median of 7 days [range 4–10]. Median ICU stay was 8 days [range 6–12]. Bioimpedance data at ICU admission and after 7 days revealed significant reductions in MM and PA after 7 days of critical illness, with values dropping from 34.3 kg to 30.6 kg (P<0.0001) for MM and from 4.90O to 4.35O (P=0.0004) for PA, respectively. The mean muscle loss was 3.84 kg ± 6.7 kg, accounting for an 8.4% reduction in MM [range 1–14]. No correlation between caloric debt (r = 0.14, P=0.13) and protein debt (r = 0.18, P=0.13) with changes in MM. Similarly, no correlation was found between caloric debt (r = -0.057, P=0.631) and protein debt (r = -0.095, P=0.424) with changes in PA.
Based on bioimpedance analysis, they concluded that ICU patients showed significant muscle loss and cellular health decline after 7 days, independent of caloric or protein intake.
Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01262-w