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Pathophysiology of malnutrition in intensive care unit

By A. Ait Hssain, B. Souweine and Noël Cano

Abstract

The prevalence of malnutrition is close to 50% at admission in hospital and particularly in intensive care unit (ICU). Most often, nutritional status worsens during the stay in ICU due to various stresses and insufficient nutrient intake. The aggression state induces an increase in energy expenditure and protein catabolism. Such a metabolic adaptation causes significant changes in body composition and more precisely a decrease in lean body mass. The decrease in muscle mass is associated with myofiber structural and functional alterations compromising patient rehabilitation. During the year following the stay in ICU, patients are characterized by the persistence or even worsening of the protein-energy malnutrition and a mortality rate of about 20%. These data underline the importance of understanding the pathophysiology of malnutrition in the ICU, discussed in this article, and its management. (c) 2011 Published by Elsevier Masson SAS

Topics: Stress, Intensive care unit, CRITICALLY-ILL PATIENTS, ENDOTHELIAL OXIDATIVE STRESS, ENERGY-EXPENDITURE, MEDICAL PATIENTS, INSULIN THERAPY, ADULT PATIENTS, SUPPORT, METABOLISM, Nutrition, Malnutrition, Muscle, MUSCLE PROTEIN-SYNTHESIS, PARENTERAL-NUTRITION, [SDV]Life Sciences [q-bio]
Publisher: 'Elsevier BV'
Year: 2011
DOI identifier: 10.1016/j.nupar.2011.01.001
OAI identifier: oai:HAL:hal-02643753v1
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