Recognizing malnutrition in adults with critical illness: Guidance statements from the Global Leadership Initiative on Malnutrition
Makaleler > Tam Makale · 2025
Yazarlar: R. Fukushima, C.W. Compher, M.I.T.D. Correia, M.C. Gonzalez, L. McKeever, K. Nakamura, Z.Y. Lee, J.J. Patel, P. Singer, C. Stoppe, J.C. Ayala, R. Barazzoni, M.M. Berger, T. Cederholm, K. Chittawatanarat, A. Cotoia, J.C. Lopez-Delgado, C.P. Earthman, G. Elke, W. Hartl, M.S. Hasan, N. Higashibeppu, G.L. Jensen, K.J. Lambell, C.C.H. Lew, J.I. Mechanick, M. Mourtzakis, G.C.C. Nogales, T. Oshima, S.J. Peterson, T.W. Rice, R. Rosenfeld, P. Sheean, F.M. Silva, P.C. Tah, Meltem UYAR
Clinical Nutrition, Uluslararası, Wos, 2025, cilt 49, ss 202-208
DOI: 10.1016/j.clnu.2025.03.011
Özet
Background 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. Methods 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. Results 1.To identify pre-existing malnutrition, we suggest evaluation within 48 hours of ICU admission when feasible (100% agreement) or within 4 days (94% agreement). 2.To identify the development and progression of malnutrition, we suggest reevaluation of all patients every 7-10 days (97% agreement). 3.To identify progressive loss of muscle mass, we suggest evaluation of muscle mass as soon as feasible (92% agreement), and again after 7-10 days (89% agreement). 4.To identify the development and progression of malnutrition prior to and after ICU discharge, we suggest reevaluating nutritional status prior to ICU discharge and during clinical visits that follow (100% 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.