Preexisting malnutrition in the ICU

Area of Science:

• Critical care medicine
• Nutritional science
• Clinical nutrition

Background:

• Preexisting malnutrition at ICU admission significantly impacts patient outcomes.
• Early identification is crucial for effective management in critically ill adults.

Purpose of the Study:

• To review recent evidence on the diagnosis, prevalence, clinical significance, and nutritional therapy of preexisting malnutrition.
• To emphasize the role of the Global Leadership Initiative on Malnutrition (GLIM) framework in current practice.

Main Methods:

• Review of recent studies applying GLIM criteria within 24-72 hours of ICU admission.
• Analysis of diagnostic advancements, including muscle-mass assessment.
• Evaluation of clinical significance and impact on patient trajectories.

Main Results:

• Malnutrition prevalence in ICUs ranges from 38% to 68% based on GLIM criteria.
• Preexisting malnutrition is linked to prolonged ICU stays, increased infections, and delayed rehabilitation.
• Nutritional therapy should focus on sustained, individualized rehabilitation post-discharge rather than early aggressive feeding.

Conclusions:

• Preexisting malnutrition is prevalent and clinically significant in critically ill patients.
• Standardized GLIM-based diagnosis facilitates early recognition and tailored nutritional strategies.
• Integrating GLIM into ICU practice improves care across the continuum.