Recognizing malnutrition in adults with critical illness: Guidance statements from the Global Leadership Initiative on Malnutrition

作者：Ryoji Fukushima, Charlene Compher, María Isabel Toulson Davisson Correia, Marı́a Cristina González, Liam McKeever, Kensuke Nakamura, Zheng‐Yii Lee, Jayshil J. Patel, Pierre Singer, Christian Stoppe, Juan Carlos Ayala, Rocco Barazzoni, Mette M. Berger, Tommy Cederholm, Kaweesak Chittawatanarat, Antonella Cotoia, Juan Carlos Lopez‐Delgado, Carrie P. Earthman, Gunnar Elke, Wolfgang H. Hartl, Mohd Shahnaz Hasan, Naoki Higashibeppu, Gordon L. Jensen, Kate Lambell, Charles Chin Han Lew, Jeffrey I. Mechanick, Marina Mourtzakis, Guillermo Contreras Nogales, Taku Oshima, Sarah J. Peterson, Todd W. Rice, Ricardo Schilling Rosenfeld, Patricia Sheean, Flávia Moraes Silva, Pei Chien Tah, Mehmet Uyar · 发表于：Clinical Nutrition · 年份：2025 · DOI：10.1016/j.clnu.2025.03.011 · 被引用次数：21 · 研究领域：Nutrition and Health in Aging、Clinical Nutrition and Gastroenterology、Vitamin C and Antioxidants Research

Background Patients with critical illness may present with disease-related malnutrition upon intensive care unit (ICU) admission. They are at risk of development and progression of malnutrition over the disease trajectory because of inflammation, dysregulated metabolism, and challenges with feeding. Methods The Global Leadership Initiative on Malnutrition (GLIM) convened a panel of 36 clinical nutrition experts to develop consensus-based guidance statements addressing the diagnosis of malnutrition during critical illness, using a modified Delphi approach with a requirement of ≥75% agreement. Results 1.To identify pre-existing malnutrition, we suggest evaluation within 48 hours of ICU admission when feasible (100% agreement) or within 4 days (94% agreement). 2.To identify the development and progression of malnutrition, we suggest reevaluation of all patients every 7-10 days (97% agreement). 3.To identify progressive loss of muscle mass, we suggest evaluation of muscle mass as soon as feasible (92% agreement), and again after 7-10 days (89% agreement). 4.To identify the development and progression of malnutrition prior to and after ICU discharge, we suggest reevaluating nutritional status prior to ICU discharge and during clinical visits that follow (100% agreement). Conclusion Research using consistent etiologic and phenotypic variables offers great potential to assess the efficacy of nutrition interventions for critically ill patients with malnutrition. Assessment of these v...