Article Text

PDF
PTU-118 The congruence between must and phase angel in detecting malnutrition in the critically ill
  1. MT Al Kalaldeh

Abstract

Introduction Proper nutritional assessment is strongly associated with nutritional failure and mortality in the critically ill (1-2). There is a little consensus on the appropriateness of using such nutritional in the intensive care (3-4).This study aimed to assesses the congruence between MUST and Phase angle measurement in predicting critically ill patients‘ nutritional status.

Method This cross-sectional observational study included critically ill patients who were fed enterally and mechanically ventilated. Patients were assessed using Malnutrition Universal Screening Tool (MUST), Phase Angel (PA) by Bioelectrical Impedance Analysis (BIA), and Acute Physiology and Chronic Health Evaluation II (APACHE II).

Results 122 patients were examined. The duration of intensive care admission was 6.25 (IQR 4.3–8.7). 78 (63.9%) of patients were acute emergency cases while 39 (32.0%) were chronic medical cases and 5 (4.1%) were other medical diagnosis. Mean of APACHE II score was 17.93 (SD 7.3). Based on this, 89 patients (73.0%) were found with low PA and the other was found normal. While MUST was ranged from 0 (Low risk) to 2 (high risk), 63 patients (51.6%) were at low risk, 27 (22.1%) were at moderate risk, and 32 (26.3%) were at high risk. Correlation revealed low significant correlation between MUST and both PA and APACHE II (R=0.41 and 0.57; p=0.035 and 0.006, respectively). However, high correlation was found between PA and APACHE II (r=0.89, p<0.001).

Conclusion The reliance on one tool for nutritional assessment would under-diagnose nutritional status in the critically ill. Although MUST is a reliable indicator, PA is another sensitive marker that can be used in combination with MUST to detect malnutrition in intensive care.

References

  1. . Feldblum I, German L, Bilenko N, A S, Enten R, Greenberg D, et al. Nutritional risk and health care use before and after an acute hospitalisation among the elderly. Nutrition. 2009;25:415–20.

  2. . Heighes P, Doig G, Sweetman E, Simpson F. An overview of evidence from systematic re-views evaluating early enteral nutrition in critically ill patients: more convincing evidence is needed. Anaesth Intensive Care. 2010;38:167–74.

  3. . Heyland DK, Stephens KE, Day AG, McClave SA. The success of enteral nutrition and ICU-acquired infections: A multicenter observational study. Clinical Nutrition. 2011;30(2):148–55.

  4. . Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gomez JM, et al. ESPEN guidelines for bioelectrical impedance analysis (part 2: utilisation in clinical practice). Clin Nutr 2004;23:1430e53.

Disclosure of Interest None Declared

  • BIA
  • Intensive care
  • Malnutrition
  • MUST
  • Phase Angel

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.