Fluids, Electrolytes, Acid-Base Disorders, and Nutrition Support

ii.

Variable

Range

Points

Age, yrs

< 50

50 - 74

> 74

< 15

15 -19

20 - 28

> 28

SOFA

< 6

6 – 9

> 9

Number of comorbidities

0 - 1

> 1

Days from hospital to ICU admission

0 - < 1

≥ 1

IL-6

0 - < 400

≥ 400

High Score = 6 to 10 points: Associated with worse clinical outcomes and

are most likely to benefit from aggressive nutrition therapy

Low Score = 0 to 5 points: These patients have a low nutrition risk

iii.

Modified NUTRIC Score (Clin Nutr 2016;35:158-62). Because IL-6 is not routinely available

for assessment, a modified NUTRIC (mNUTRIC) score has been validated, which omits IL-6.

An mNUTRIC score of 5 or greater is considered high nutrition risk.

American Society for Parenteral and Enteral Nutrition (ASPEN) International Consensus

Nomenclature (JPEN J Parenter Enteral Nutr 2010;34:156-9)

Starvation-related malnutrition (e.g., anorexia nervosa)

ii.

Chronic disease-related malnutrition (e.g., inflammatory bowel disease, organ failure)

iii.

Acute disease or injury-related malnutrition (e.g., major infection, burns, trauma)

“Classic” definition – Not in favor with conventional assessment techniques and tools

Marasmus (e.g., decreased fat/muscle protein stores but normal serum proteins)

ii.

Kwashiorkor (e.g., normal fat, decreased muscle protein, and serum proteins)

iii.

Kwashiorkor-Marasmus mix (decreased fat, muscle protein, and serum proteins)

Based on body mass index (BMI) = weight (kg)/height2 (m2) – Should not be used alone to identify

malnutrition

Less than 18.5 kg/m2: Underweight

ii.

18.5–24.9 kg/m2: Normal

iii.

25–29.9 kg/m2: Overweight

iv.

30–34.9 kg/m2: Class I obesity

35–39.9 kg/m2: Class II obesity

vi.

Greater than 40 kg/m2: Class III obesity