Association between nutritional risk status and both diaphragmatic dysfunction and diaphragm atrophy in medical ıntensive care unit patients.

Inci K., Macit Aydın E., Aygencel G., Türkoğlu M.

Nutricion hospitalaria, vol.41, no.2, pp.286-292, 2024 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 41 Issue: 2
  • Publication Date: 2024
  • Doi Number: 10.20960/nh.05011
  • Journal Name: Nutricion hospitalaria
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Fuente Academica Plus, CINAHL, Food Science & Technology Abstracts, MEDLINE, Directory of Open Access Journals, DIALNET
  • Page Numbers: pp.286-292
  • Keywords: Diaphragm atrophy, Diaphragmatic dysfunction, Malnutrition risk, Mid-upper arm circumference, Nutritional risk screening
  • Gazi University Affiliated: Yes

Abstract

Aim: critical illness often leads to malnutrition and diaphragmatic dysfunction (DD), common in intensive care units (ICU). Ultrasonography (US) is a potent tool for detecting DD. This study examines the connection between malnutrition risk and DD in ICU patients using ultrasonographic diaphragm measurements in medical ICU patients. Methods: we assessed nutritional risk using risk screening tools and mid-upper arm circumference measurements (MUAC). Diaphragm atrophy (DA) and DD were evaluated by measuring diaphragmatic excursion (DE), thickness, and thickening fraction (TF) by US. We then compared these diaphragmatic measurements in patients based on their nutritional risk scores. Results: of the fifty patients studied, 54 % to 78 % were at risk of malnutrition, 28 % exhibited diaphragm atrophy (DA), and 24 % showed DD upon ICU admission. Malnutrition risk diagnosed by all nutritional risk screening tools was significantly more frequent in patients with DD, while diagnosed by MUAC was considerably higher in patients with DA. A total of 16 patients (32 %) died during their ICU stay, with DD, DA, and malnutrition risks (as identified by the mNUTRIC Score) being more prevalent among non-survivors (p < 0.05). Malnutrition risk (as determined by the mNUTRIC Score) was an independent risk factor for DD [OR (95 % CI): 6.6 (1.3-34), p = 0.03]. Conclusion: malnutrition risk may be significantly associated with DD and DA in medical ICU patients upon ICU admission.