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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Main Authors: I. V. Sergeev, M. V. Petrova, A. E. Shestopalov, M. M. Kanarsky, O. B. Lukyanets, I. A. Yarotskaya, Yu. Yu. Nekrasova
Format: Article
Language:English
Published: Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia 2023-08-01
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.
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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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AT oblukyanets nutritionalstatusofpatientswithchroniccriticalillness
AT iayarotskaya nutritionalstatusofpatientswithchroniccriticalillness
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