Bedside nutrition evaluation and physical assessment techniques in critical illness

Purpose of review The purpose of this review is to highlight emerging techniques used to determine body composition early in ICU stay, their prediction of poor outcome, and what is required before they can be more widely used. Recent findings Opportunistic use of imaging techniques to assess muscle mass shows promise with regard to predicting patient outcomes; however, some of these techniques are expensive. Mid-arm muscle circumference and physical assessments of muscle wasting and subcutaneous fat loss using the subjective global assessment (SGA) are simple cheap tools that can be undertaken at the ICU patient bedside. Furthermore, each of these simple measures is a better predictor of patient outcome than BMI. Summary Mid-arm muscle circumference, SGA fat loss, and SGA muscle wasting have each been found to be better predictors of poor outcome than BMI in ICU patients. Mid-arm muscle circumference, SGA fat loss, and SGA muscle wasting may be able to identify patients who are most likely to benefit from enhanced nutrition support. We need further research incorporating the use of these simple measures to evaluate their ability to accurately identify patients most likely to benefit from enhanced nutritional support.