Simple assessment of the nutritional status in the critically ill patient

The assessment of nutritional status in intensive care patients can be easily accomplished. The first step is to record the patient's complete medical and social history, and to perform a thorough clinical examination in search of signs of nutritional depletion. Several tests, simple and unexpensive, are available to assess the different compartments of the body such as: anthropometric measurements, weight, skinfold thickness and arm muscle circumference and area; biochemical assays, 24-h urinary excretion of creatinine and 3 methylhistidine, serum albumin, transferrin, thyroxin binding prealbumin (TBPA) and retinol binding protein (RBP). The authors report their own data, collected in 150 patients. Nearly all the patients' values are significantly lower than those of the controls; CHI, serum proteins and energy are related to the prognosis; most variables show significant interrelationship: TBPA and RBP are the most frequently decreased values.