Exploitation of diagnostic computed tomography scans to assess the impact of nutrition support on body composition changes in respiratory failure patients
Open accessAbstract
Background: Assessment of nutritional status in intensive care unit (ICU) patients is limited. Computed tomography (CT) scans that include the first to fifth lumbar region completed for diagnostic purposes measures fat and lean body mass (LBM) depots and are frequently done in ICU populations and can be used to quantify fat and LBM depots. The purpose of this study was to assess if these scans could measure change in skeletal muscle (SKT), visceral adipose (VAT), and intermuscular adipose (IMAT) tissue and to examine the association between the amount of energy and protein received and changes in these depots. Methods: Cross‐sectional area of SKT, VAT, and IMAT from CT scans at the third lumbar region was quantified at 2 time points (CT1 and CT2). Change scores between CT1 and CT2 for each of these depots and the percentage of estimated energy/protein needs received were determined in 33 adults that with acute respiratory failure. Descriptive statistics and multiple regression was used to evaluate the influence of baseline characteristics and the percentage energy/protein needs received between CT1 and CT2 on percentage change/day between CT1 and CT2 on SKM, IMAT, and VAT. Results: Participants were on average (SD) 59.7 (16) years old, received 41% of energy and 57% of protein needs. The average time between CT1 and CT2 was 10 (5) days. SKM declined 0.49%/day (men P = .07, women P = .09) and percentage of energy needs received reduced loss (β = 0.024, P = .03). No change in VAT or IMAT occurred. Conclusions: CT scans can be exploited to assess change in body composition in ICU patients and may assist in detecting the causal link between nutritional support and outcomes in future clinical trials.
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Patients with low muscle mass found at admission by computerized tomography have a higher length of stay and higher mortality.
“Patients with low muscle mass found at admission by computerized tomography have a higher length of stay and higher mortality [25].”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [25]
The CT Image Analysis section (page unavailable) confirms that the study quantified skeletal muscle using CT scans. The introductory text says malnourished patients generally have longer hospitalizations and higher mortality, but the Results (page unavailable) report muscle changes between scans, not an association between low muscle mass on an admission CT and either outcome. (LLM, conf=0.82)
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- Authors
- Braunschweig, C. A., Sheean, P. M., Peterson, S. J., Gomez Perez, S., Freels, S., Troy, K. L., Ajanaku, F. C., Patel, A., Sclamberg, J. S., & Wang, Z.
- Affiliations
- University of Illinois Chicago (US)
- Rush University Medical Center (US)
- Worcester Polytechnic Institute (US)
- Howard University (US)
- Corresponding author
- Braunschweig, Carol A.
- ORCID
- Venue
- Journal of Parenteral and Enteral Nutrition
- Publisher
- Wiley
- Published
- 2013-08-23
- Volume
- 38
- Issue
- 7
- Pages
- 880-885
- ISSN
- 0148-6071 (ISSN-L)
- 1941-2444
- PMC
- PMC3947493
- OpenAlex
- W2075002661
- Cited by
- 81
- References
- 47
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 15 · 2023: 4 · 2022: 2 · 2021: 8 · 2020: 9 · 2019: 6 · 2018: 8 · 2017: 4 · 2016: 7 · 2015: 6 · 2014: 6
- FWCI
- 5.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Parenteral and Enteral Nutrition (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute
- National Institutes of Health ((R01HL093142–01S109))
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- body composition, nutritional assessment, acute respiratory failure, intensive care unit patients, nutritional support, skeletal muscle mass, visceral adipose tissue, intermuscular adipose tissue, energy and protein intake
- MeSH terms
- Adipose Tissue, Adult, Aged, Body Composition, Body Fluid Compartments, Energy Intake, Dietary Proteins, Female, Humans, Intensive Care Units, Lumbosacral Region, Male, Middle Aged, Nutritional Requirements, Nutritional Status, Obesity, Respiratory Insufficiency, Tomography, Nutrition Assessment, Critical Illness, Muscle, Skeletal, Nutritional Support, Intra-Abdominal Fat
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