Nutritional Status of Patients with Chronic Critical Illness
Material and methods. We examined 23 patients with chronic critical illness who were in a minimally conscious state (MCS) with 10.9±2.5 scores on the FOUR (Full Outline of Unresponsiveness) Score Coma Scale. Indicators of carbohydrate, lipid, protein and energy exchange metabolism were evaluated usi...
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Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2023-08-01
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| Series: | Общая реаниматология |
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| Online Access: | https://www.reanimatology.com/rmt/article/view/2329 |
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| author | I. V. Sergeev M. V. Petrova A. E. Shestopalov M. M. Kanarsky O. B. Lukyanets I. A. Yarotskaya Yu. Yu. Nekrasova |
| author_facet | I. V. Sergeev M. V. Petrova A. E. Shestopalov M. M. Kanarsky O. B. Lukyanets I. A. Yarotskaya Yu. Yu. Nekrasova |
| author_sort | I. V. Sergeev |
| collection | DOAJ |
| description | Material and methods. We examined 23 patients with chronic critical illness who were in a minimally conscious state (MCS) with 10.9±2.5 scores on the FOUR (Full Outline of Unresponsiveness) Score Coma Scale. Indicators of carbohydrate, lipid, protein and energy exchange metabolism were evaluated using specimens sampled in the morning hours. Nutritional support was provided by isocaloric isonitrogenic mixtures.Results. Blood biochemistry showed decreases in total protein and albumin levels in 86.9% and 91.3% of patients, respectively. The tests also revealed decreased concentrations of several amino acids, including essential amino acids: histidine (38.3±13.07 µmol/l), methionine (12.68±3.81 µmol/l), threonine (61.6 [58.5;87.7] µmol/l), tryptophan (33.06±15.95 µmol/l), and non-essential amino acids: arginine (40.50 [22.2; 46.9] µmol/l), glutamic acid (124.5±39.29 µmol/l), tyrosine (37.97±10.12 µmol/l). Some correlations between the concentrations of individual amino acids and other indicators were revealed, such as histidine and CRP (r=–0.68, P=0.043), tryptophan and CRP (r=–0.86, P=0.002), histidine and leukocyte count (r=–0.76, P=0.015), methionine and lysine (r=0.88, P=0.008), methionine and patient's weight (r=–0.68, P=0.042). A relationship between threonine concentration and the level of consciousness on the FOUR scale (r=–0.73, P=0.037) was also found. All patients demonstrated significant alterations of carbohydrate and lipid metabolism.Conclusion. Alteration of adequate protein metabolism seems to be the most affected constituent in the nutritional status of patients with chronic critical illness. It is manifested by a decrease in the concentration of total protein and a number of essential and non-essential amino acids, which implies the importance of highprotein nutritional support and correction of the amino acid profile. |
| format | Article |
| id | doaj-art-a679f284f7484bb389b82b1d3a3f77bc |
| institution | Kabale University |
| issn | 1813-9779 2411-7110 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia |
| record_format | Article |
| series | Общая реаниматология |
| spelling | doaj-art-a679f284f7484bb389b82b1d3a3f77bc2025-08-20T03:35:08ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102023-08-0119441110.15360/1813-9779-2023-4-23291913Nutritional Status of Patients with Chronic Critical IllnessI. V. Sergeev0M. V. Petrova1A. E. Shestopalov2M. M. Kanarsky3O. B. Lukyanets4I. A. Yarotskaya5Yu. Yu. Nekrasova6Federal Research and Clinical Center of Intensive Care Medicine and RehabilitologyFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; Peoples Friendship University of RussiaFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; Russian Medical Academy of Continuous Professional Education, Ministry of Health of RussiaFederal Research and Clinical Center of Intensive Care Medicine and RehabilitologyFederal Research and Clinical Center of Intensive Care Medicine and RehabilitologyKonchalovsky City Clinical Hospital, Moscow City Health DepartmentFederal Research and Clinical Center of Intensive Care Medicine and RehabilitologyMaterial and methods. We examined 23 patients with chronic critical illness who were in a minimally conscious state (MCS) with 10.9±2.5 scores on the FOUR (Full Outline of Unresponsiveness) Score Coma Scale. Indicators of carbohydrate, lipid, protein and energy exchange metabolism were evaluated using specimens sampled in the morning hours. Nutritional support was provided by isocaloric isonitrogenic mixtures.Results. Blood biochemistry showed decreases in total protein and albumin levels in 86.9% and 91.3% of patients, respectively. The tests also revealed decreased concentrations of several amino acids, including essential amino acids: histidine (38.3±13.07 µmol/l), methionine (12.68±3.81 µmol/l), threonine (61.6 [58.5;87.7] µmol/l), tryptophan (33.06±15.95 µmol/l), and non-essential amino acids: arginine (40.50 [22.2; 46.9] µmol/l), glutamic acid (124.5±39.29 µmol/l), tyrosine (37.97±10.12 µmol/l). Some correlations between the concentrations of individual amino acids and other indicators were revealed, such as histidine and CRP (r=–0.68, P=0.043), tryptophan and CRP (r=–0.86, P=0.002), histidine and leukocyte count (r=–0.76, P=0.015), methionine and lysine (r=0.88, P=0.008), methionine and patient's weight (r=–0.68, P=0.042). A relationship between threonine concentration and the level of consciousness on the FOUR scale (r=–0.73, P=0.037) was also found. All patients demonstrated significant alterations of carbohydrate and lipid metabolism.Conclusion. Alteration of adequate protein metabolism seems to be the most affected constituent in the nutritional status of patients with chronic critical illness. It is manifested by a decrease in the concentration of total protein and a number of essential and non-essential amino acids, which implies the importance of highprotein nutritional support and correction of the amino acid profile.https://www.reanimatology.com/rmt/article/view/2329nutritional statuscritical illnessprotein metabolismamino acid profileamino acidsprolonged disturbance of consciousness |
| spellingShingle | I. V. Sergeev M. V. Petrova A. E. Shestopalov M. M. Kanarsky O. B. Lukyanets I. A. Yarotskaya Yu. Yu. Nekrasova Nutritional Status of Patients with Chronic Critical Illness Общая реаниматология nutritional status critical illness protein metabolism amino acid profile amino acids prolonged disturbance of consciousness |
| title | Nutritional Status of Patients with Chronic Critical Illness |
| title_full | Nutritional Status of Patients with Chronic Critical Illness |
| title_fullStr | Nutritional Status of Patients with Chronic Critical Illness |
| title_full_unstemmed | Nutritional Status of Patients with Chronic Critical Illness |
| title_short | Nutritional Status of Patients with Chronic Critical Illness |
| title_sort | nutritional status of patients with chronic critical illness |
| topic | nutritional status critical illness protein metabolism amino acid profile amino acids prolonged disturbance of consciousness |
| url | https://www.reanimatology.com/rmt/article/view/2329 |
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