Nutritional Assessment and Body Composition in Critically Ill Children as Prognostic Indicators

Abstract

Malnutrition is very common in critically ill patients, mainly children and adolescents, and it increases morbidity, length of stay, medical costs, and mortality. Anthropometric and body composition assessment are basic components for monitoring nutritional status. In addition, it appears to be able to predict several clinical outcomes in these patients. This review describes studies evaluating usefulness of nutritional and prognostic assessment tools in critically ill patients. Although anthropometry is difficult to interpret in critically ill patients, it is very useful for classifying nutrition status, as well as for planning nutritional therapy (NT) and nutrition monitoring. Several traditional nutritional markers (zinc, selenium, prealbumin, and HDL) have been used as inflammatory and, consequently, prognostic indicators. Body composition indicators as phase angle obtained by bioelectrical impedance and arm circumference have shown a strong ability to predict outcomes in a wide variety of clinical situations, including critically ill children and adolescents. Early intervention targeting nutrition assessment can prevent or minimize the complications of undernutrition in the intensive care unit. Thus, improving the accuracy of nutritional and prognostic evaluation is of paramount importance in the clinical management of critically ill patients.