1. Introduction
systemic illness, Sepsis, critically ill septic, Critically ill, infection, sepsis, muscle loss, septic
SYSTEMIC ILLNESS, SEPSIS, CATABOLIC STATE, DYSFUNCTION, CRITICALLY ILL, INFECTION, SECONDARY, CRITICALLY ILL, MALNUTRITION, SEPSIS, PATHOLOGY
The study aimed to determine whether using body composition data acquired through bio-electrical impedance analysis (BIA) to adjust diet formulas could improve outcomes in septic patients. There were 132 septic patients in medical intensive care units enrolled in the prospective, randomized, double-blind, interventional study. For the intervention group, dietitians had access to BIA data for adjusting diet formulas according to body composition variables on days 1, 3, and 8. The patients were also stratified based on nutritional risk using the modified Nutrition Risk in Critically ill (mNUTRIC) score. Patients with intervention were more likely to achieve caloric and protein intake goals compared to the control group, especially in the low-risk group. The intervention did not significantly affect mortality, but the survival curves suggested potential benefits. The high-risk group had longer ICU stays and mechanical ventilation duration, which were mitigated by the intervention. Certain body composition variables (e.g., extracellular water to total body water ratio and phase angle) showed differences between high-risk and low-risk groups and may be related to patient outcomes. Non-invasive body composition assessment using BIA can help dietitians adjust diet formulas for critically ill septic patients. Body composition variables may be associated with sepsis outcomes, but further research with larger patient numbers is needed to confirm these findings.Sepsis, a life-threatening systemic illness characterized by organ dysfunction resulting from infection, is a common reason for admission to intensive care units (ICUs) and is associated with high mortality rates [Hospitalized patients are often at risk of malnutrition, which may be due to disease-related catabolic states or inadequate nutrition supply [Body composition refers to the percentage of fat, bone, and muscle in a person’s body. Non-invasive bio-electrical impedance analysis (BIA) can be used to analyze body composition, allowing for the assessment of different weight components such as lean body mass and fat mass. This method is based on the electrical properties of tissues and reflects the relationship between water content and the body’s electrical resistance. Different body tissues have different water content, electrical conductivity, and electrical resistance. A change in these parameters in individual organs and tissues indicates the presence of pathology. We used these changes in sepsis to help the dietitian. By monitoring body composition variables for muscle loss, fluid levels, and cellular health, we may gain valuable insights into sepsis outcomes. In particular, lean analysis enables us to monitor lean body mass and extracellular water (ECW)/total body water (TBW) values in the body. Additionally, phase angle (PA), which measures cellular resistivity and reflects cell membrane integrity and overall cellular health, could serve as a prognostic factor of survival [In our study, we defined nutritional intervention as the dietitian’s ability to utilize the patient’s BIA data as an additional reference for prescribing the appropriate diet formula. The primary aim of this study was to determine whether septic patients in the nutritional intervention group experienced better outcomes ([1] primary outcomes: length of stay and mortality, [2] secondary outcomes: amount of caloric and protein intake, percentage of patients meeting caloric and protein goals) compared to septic patients in the control (non-interventional) group. The dietitian in charge of the patients in the nutritional intervention group was provided with the BIA data, whereas the control group did not receive such intervention. Additionally, patients were stratified by nutritional risk according to the modified Nutrition Risk in Critically Ill (mNUTRIC) score for further analysis.