Biomarkers in critical care
nutrition
by Christian Stoppe, Sebastian Wendt, Nilesh M. Mehta,
Charlene Compher, Jean-Charles Preiser, Daren K. Heyland and Arnold S. Kristof
Critical Care volume 24,
Article number: 499 (2020)
The goal of nutrition support is to provide the substrates
required to match the bioenergetic needs of the patient and promote the net
synthesis of macromolecules required for the preservation of lean mass, organ
function, and immunity. Contemporary observational studies have exposed the
pervasive undernutrition of critically ill patients and its association with
adverse clinical outcomes. The intuitive hypothesis is that optimization of
nutrition delivery should improve ICU clinical outcomes. It is therefore
surprising that multiple large randomized controlled trials have failed to
demonstrate the clinical benefit of restoring or maximizing nutrient intake.
This may be in part due to the absence of biological markers that identify
patients who are most likely to benefit from nutrition interventions and that
monitor the effects of nutrition support. Here, we discuss the need for
practical risk stratification tools in critical care nutrition, a proposed
rationale for targeted biomarker development, and potential approaches that can
be adopted for biomarker identification and validation in the field…
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