Debapriya Datta1, Raymond Foley1, Rong Wu2, James Grady2, Paul Scalise3. 1. 1 Division of Pulmonary & Critical Care Medicine, University of Connecticut Health Center, Farmington, CT, USA. 2. 2 Biostatistics Center, University of Connecticut Health Center, Farmington, CT, USA. 3. 3 Division of Pulmonary & Critical Care Medicine, Hospital for Special Care, New Britain, CT, USA.
Abstract
OBJECTIVE: Malnutrition is common in chronic critically ill patients on prolonged mechanical ventilation (PMV) and may affect weaning. The creatinine height index (CHI), which reflects lean muscle mass, is regarded as the most accurate indicator of malnutrition. The objective of this study was to determine the impact of CHI in comparison with other traditional nutritional indices on successful weaning and survival in patients on PMV after critical illness. METHODS: Records of 167 patients on PMV following critical illness, admitted for weaning, were reviewed. Parameters studied included age, gender, body mass index (BMI), percentage ideal body weight (%IBW), total protein, albumin, prealbumin, hemoglobin (Hb), and cause of respiratory failure. Number successfully weaned and number discharged alive and time to wean and time to discharge alive were determined from records. The CHI was calculated from 24-hour urine creatinine using a standard formula. Unpaired 2-sample t test was performed to determine the association between the studied nutritional parameters and outcomes. Predictive value of studied parameters for successful weaning and survival was determined by multivariate logistic regression analysis to model dichotomous outcome of successful weaning and survival. RESULTS: Mean age was 68 ± 14 years, 49% were males, 64% were successfully weaned, and 65.8% survived. Total protein, Hb, and CHI had a significant impact on successful weaning. Weight, %IBW, BMI, and CHI had a significant effect on survival. Of all parameters, CHI was most strongly predictive of successful weaning and survival. CONCLUSIONS: The CHI is a strong predictor of successful weaning and survival in patients on PMV.
OBJECTIVE:Malnutrition is common in chronic critically illpatients on prolonged mechanical ventilation (PMV) and may affect weaning. The creatinine height index (CHI), which reflects lean muscle mass, is regarded as the most accurate indicator of malnutrition. The objective of this study was to determine the impact of CHI in comparison with other traditional nutritional indices on successful weaning and survival in patients on PMV after critical illness. METHODS: Records of 167 patients on PMV following critical illness, admitted for weaning, were reviewed. Parameters studied included age, gender, body mass index (BMI), percentage ideal body weight (%IBW), total protein, albumin, prealbumin, hemoglobin (Hb), and cause of respiratory failure. Number successfully weaned and number discharged alive and time to wean and time to discharge alive were determined from records. The CHI was calculated from 24-hour urine creatinine using a standard formula. Unpaired 2-sample t test was performed to determine the association between the studied nutritional parameters and outcomes. Predictive value of studied parameters for successful weaning and survival was determined by multivariate logistic regression analysis to model dichotomous outcome of successful weaning and survival. RESULTS: Mean age was 68 ± 14 years, 49% were males, 64% were successfully weaned, and 65.8% survived. Total protein, Hb, and CHI had a significant impact on successful weaning. Weight, %IBW, BMI, and CHI had a significant effect on survival. Of all parameters, CHI was most strongly predictive of successful weaning and survival. CONCLUSIONS: The CHI is a strong predictor of successful weaning and survival in patients on PMV.
Authors: Carlos Alfredo Galindo Martín; Reyna Del Carmen Ubeda Zelaya; Enrique Monares Zepeda; Octavio Augusto Lescas Méndez Journal: J Nutr Metab Date: 2018-04-01
Authors: Antuani Rafael Baptistella; Laura Maito Mantelli; Leandra Matte; Maria Eduarda da Rosa Ulanoski Carvalho; João Antonio Fortunatti; Iury Zordan Costa; Felipe Gabriel Haro; Vanda Laís de Oliveira Turkot; Shaline Ferla Baptistella; Diego de Carvalho; João Rogério Nunes Filho Journal: PLoS One Date: 2021-03-18 Impact factor: 3.240