Nutritional Assessment in Critically Ill

Patients
Objectives
By the end of this presentation learners will be able to;
• Define nutritional assessment
• Illuminate the significance of nutritional assessment in critically ill
patients
• Discuss the purpose of nutritional assessment
• Discuss the elements of nutritional assessment
• Conclude the presentation

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Definition

A nutrition assessment is an in-depth evaluation of both objective and

subjective data related to an individual's food and nutrient intake,
lifestyle, and medical history. (Carole.S.M 2000)

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Statistics

Malnutrition prevalence on the day of discharge (58.62%),on admission

(28.8%) according to SGA

Malnutrition on discharge day increased in the patients in the ICU according

to SGA.

Anthropometric measurements are better predictors of the nutritional

outcome of our critically ill patients than were biochemical tests.
(Hejazi.N,et.al,2016),
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Purpose

• Identify patient who is at risk of malnutrition

• Identify who is malnourished

• To develop a health care programm and plan interventions

• Measure the effectiveness of programm and interventions

• Predict the probability of better or worse outcome

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History taking

• BMI <18.5

• Weight loss in last three months

• Dietary intake reduced in last week

• Severe illnesses

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Subjective global assessment(SGA)

• History of weight changes

• History of dietary changes

• Functional capacity

• Effects of diseases on nutritional requirement

• Physical appearance

• Persistent GI symptoms
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SGA

Patient classified as:

• Well nourished

• Moderate/suspected malnutrition

• Severe malnutrition

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Elements of nutritional assessment

• Anthropometric

• Biochemical data

• Clinical data

• Dietary data

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Anthropometric measurements
• Anthropometry is the measurement of height, weight and proportions
• Essential component of clinical examination
• Used to evaluate over and under nutrition
• Mid arm circumference
• Skin fold thickness
• Waist and hip ratio
• Head and chest ratio

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Biochemical data

• Hemoglobin, iron, ferritin, albumin, pre albumin

• Stool examination

• Vitamin and minerals levels

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Dietary data

Nutritional intake is assessed by different methods

Good nutritional history should be obtained

• 24 hours nutritional recall

• Food frequency questionnaire

• Dietary history since early life

• Food diary technique

• Observed food consumption

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Clinical data

• General clinical/physical examination with special attention to the

organs like hair, nails, eyes, gums, tongue, muscles, bones and thyroid
gland

• Detection of relevant signs helps in diagnosis of certain diseases

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Body Mass Index
• International standard used for nutritional assessment is body mass
index(BMI)

BMI is calculated by using formula:

BMI= Weight(kg)/ height(m2)

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Reference
Carole S.M(2000) Nutritional Assessment. Retrieved from,
https://www.diet.com/g/nutritional -assessment

Hejazi.N,et.al,(2016),Nutritional Assessment in Critically Ill Patients, Iranian

Journal Of Medical Sciences,V41, No3, retrieved from-
https://www.sketchbubble.com/en/powerpoint-bmi-chart.html

Nutritional and well being (2014).Retrieved from-

http://www.encyclopedia.com/sports-and-everyday-life/food-and- drink/
food-and-cooking/
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