Measuring body composition in hemodialysis patients: before or after hemodialysis?

Summary: Background &amp; Aims: Body composition and clinical outcomes such as mortality and quality of life are strongly correlated in patients with chronic kidney disease. Since body weight and body mass index do not reflect body composition, measuring body composition is essential. In hemodialysis patients, there is an equipoise about the best moment to measure body composition; before or after hemodialysis. Our aim was to explore the agreement between bio-impedance spectroscopy (BIS) derived body composition indices before and after hemodialysis. Methods: We performed BIS measurements in a cohort of hemodialysis patients. Patients were divided into group 1: measurements before and  0.810, P < 0.001). Conclusions: These results suggest that BIS-derived body composition measurements can be performed both before and after hemodialysis. If body composition is measured after hemodialysis, then measurements should be performed ≥30 min after the end of the session

Monitoring muscle mass using ultrasound: a key role in critical care

PURPOSE OF REVIEW: The loss of muscle mass in critically ill patients contributes to morbidity and mortality, and results in impaired recovery of physical functioning. The number of publications on the topic is increasing. However, there is a lack of consistent methodology and the most optimal methodology remains unclear, hampering its broad use in clinical practice. RECENT FINDINGS: There is a large variety of studies recently published on the use of ultrasound for assessment of muscle mass. A selection of studies has been made, focusing on monitoring of muscle mass (repeated measurements), practical aspects, feasibility and possible nutrition and physical therapy interventions. In this review, 14 new small (n = 19-121) studies are categorized and reviewed as individual studies. SUMMARY: The use of ultrasound in clinical practice is feasible for monitoring muscle mass in critically ill patients. Assessment of muscle mass by ultrasound is clinically relevant and adds value for guiding therapeutic interventions, such as nutritional and physical therapy interventions to maintain muscle mass and promote recovery in critically ill patients

Monitoring muscle mass using ultrasound: a key role in critical care

PURPOSE OF REVIEW: The loss of muscle mass in critically ill patients contributes to morbidity and mortality, and results in impaired recovery of physical functioning. The number of publications on the topic is increasing. However, there is a lack of consistent methodology and the most optimal methodology remains unclear, hampering its broad use in clinical practice. RECENT FINDINGS: There is a large variety of studies recently published on the use of ultrasound for assessment of muscle mass. A selection of studies has been made, focusing on monitoring of muscle mass (repeated measurements), practical aspects, feasibility and possible nutrition and physical therapy interventions. In this review, 14 new small (n = 19-121) studies are categorized and reviewed as individual studies. SUMMARY: The use of ultrasound in clinical practice is feasible for monitoring muscle mass in critically ill patients. Assessment of muscle mass by ultrasound is clinically relevant and adds value for guiding therapeutic interventions, such as nutritional and physical therapy interventions to maintain muscle mass and promote recovery in critically ill patients

Early high protein provision and mortality in ICU patients including those receiving continuous renal replacement therapy

Background: Findings on the association between early high protein provision and mortality in ICU patients are inconsistent. The relation between early high protein provision and mortality in patients receiving CRRT remains unclear. The aim was to study the association between early high protein provision and hospital and ICU mortality and consistency in subgroups. Methods: A retrospective cohort study was conducted in 2618 ICU patients with a feeding tube and mechanically ventilated ≥48 h (2003–2016). The association between early high protein provision (≥1.2 g/kg/day at day 4 vs. 50%, results remained robust in all groups except for patients receiving CRRT. Conclusions: Early high protein provision is associated with lower hospital and ICU mortality in ICU patients, including CRRT-receiving patients. There was no association for septic patients

Early high protein provision and mortality in ICU patients including those receiving continuous renal replacement therapy

Background: Findings on the association between early high protein provision and mortality in ICU patients are inconsistent. The relation between early high protein provision and mortality in patients receiving CRRT remains unclear. The aim was to study the association between early high protein provision and hospital and ICU mortality and consistency in subgroups. Methods: A retrospective cohort study was conducted in 2618 ICU patients with a feeding tube and mechanically ventilated ≥48 h (2003–2016). The association between early high protein provision (≥1.2 g/kg/day at day 4 vs. 50%, results remained robust in all groups except for patients receiving CRRT. Conclusions: Early high protein provision is associated with lower hospital and ICU mortality in ICU patients, including CRRT-receiving patients. There was no association for septic patients

Early high protein provision and mortality in ICU patients including those receiving continuous renal replacement therapy

BACKGROUND: Findings on the association between early high protein provision and mortality in ICU patients are inconsistent. The relation between early high protein provision and mortality in patients receiving CRRT remains unclear. The aim was to study the association between early high protein provision and hospital and ICU mortality and consistency in subgroups. METHODS: A retrospective cohort study was conducted in 2618 ICU patients with a feeding tube and mechanically ventilated ≥48 h (2003-2016). The association between early high protein provision (≥1.2 g/kg/day at day 4 vs. 50%, results remained robust in all groups except for patients receiving CRRT. CONCLUSIONS: Early high protein provision is associated with lower hospital and ICU mortality in ICU patients, including CRRT-receiving patients. There was no association for septic patients