Metabolic predictors of life-threatening conditions in patients in chronic critical illness

Abstract

Due to modern advances in medicine, more and more patients survive after severe acute diseases. However, some such patients remain dependent on life-support systems. Therefore, a chronic critical condition is an urgent problem for patients in the intensive care unit. The main syndrome of this complex is maladaptive responses to long-term existing stress factors. This review examines the main pathophysiological mechanisms of chronic critical illness, as well as the resulting metabolic disorders. A literature search was conducted in the English-language databases of medical and biological publications PubMed and Scopus, as well as the Russian bibliographic system RSCI. The coverage interval was the last 20 years. Emphasis was placed on the systemic inflammatory reaction; the reaction of hypermetabolism-hypercatabolism; disorders of carbohydrate, protein, and fat metabolism; and the development of secondary sarcopenia. In conclusion, the volume of metabolic control and intensive nutritional and metabolic support, which are critical components of a comprehensive approach to the treatment of chronic critical illness, are key considerations considered.

Keywords

chronic critical illness / brain damage / metabolism / sarcopenia / nutritional support

References

[1] Girard K, Raffin TA. The chronically critically ill: to save or let die? Respir Care. 1985;30(5):339–347.

[2] Girard K., Raffin T.A. The chronically critically ill: to save or let die? // Respir Care. 1985. Vol. 30, N 5. P. 339–347.

[3] Van den Berghe G, de Zegher F, Bouillon R. Clinical review 95: Acute and prolonged critical illness as different neuroendocrine paradigms. J Clin Endocrinol Metab. 1998;83(6):1827–1834. doi: 10.1210/jcem.83.6.4763

[4] Van den Berghe G., de Zegher F., Bouillon R. Clinical review 95: Acute and prolonged critical illness as different neuroendocrine paradigms // J Clin Endocrinol Metab. 1998. Vol. 83, N 6. P. 1827–1834. doi: 10.1210/jcem.83.6.4763

[5] Van den Berghe G, Wouters P, Carlsson L, et al. Leptin levels in protracted critical illness: effects of growth hormonesecretagogues and thyrotropin-releasing hormone. J Clin Endocrinol Metab. 1998; 83(9):3062–3070. doi: 10.1210/jcem.83.9.5120

[6] Van den Berghe G., Wouters P., Carlsson L., et al. Leptin levels in protracted critical illness: effects of growth hormonesecretagogues and thyrotropin-releasing hormone // J Clin Endocrinol Metab. 1998. Vol. 83, N 9. P. 3062–3070. doi: 10.1210/jcem.83.9.5120

[7] Carson SS. Definitions and epidemiology of the chronically critically ill. Respir Care. 2012;57(6):848–856. doi: 10.4187/respcare.01736

[8] Carson S.S. Definitions and epidemiology of the chronically critically ill // Respir Care. 2012. Vol. 57, N 6. P. 848–856. doi: 10.4187/respcare.01736

[9] Maguire JM, Carson SS. Strategies to combat chronic critical illness. Curr Opin Crit Care. 2013;19(5):480–487. doi: 10.1097/MCC.0b013e328364d65e

[10] Maguire J.M., Carson S.S. Strategies to combat chronic critical illness // Curr Opin Crit Care. 2013. Vol. 19, N 5. P. 480–487. doi: 10.1097/MCC.0b013e328364d65e

[11] MacIntyre NR, Epstein SK, Carson S, et al. Management of patients requiring prolonged mechanical ventilation: report of a NAMDRC consensus conference. Chest. 2005;128(6):3937–3954. doi: 10.1378/chest.128.6.3937

[12] MacIntyre N.R., Epstein S.K., Carson S., et al. Management of patients requiring prolonged mechanical ventilation: report of a NAMDRC consensus conference // Chest. 2005. Vol. 128, N 6. P. 3937–3954. doi: 10.1378/chest.128.6.3937

[13] Fenner BP, Darden DB, Kelly LS, et al. Immunological Endotyping of Chronic Critical Illness After Severe Sepsis. Front Med (Lausanne). 2021;7:616694. doi: 10.3389/fmed.2020.616694

[14] Fenner B.P., Darden D.B., Kelly L.S., et al. Immunological Endotyping of Chronic Critical Illness After Severe Sepsis // Front Med (Lausanne). 2021. Vol. 7. P. 616694. doi: 10.3389/fmed.2020.616694

[15] Cox MC, Brakenridge SC, Stortz JA, et al. Abdominal sepsis patients have a high incidence of chronic critical illness with dismal long-term outcomes. Am J Surg. 2020;220(6):1467–1474. doi: 10.1016/j.amjsurg.2020.07.016

[16] Cox M.C., Brakenridge S.C., Stortz J.A., et al. Abdominal sepsis patients have a high incidence of chronic critical illness with dismal long-term outcomes // Am J Surg. 2020. Vol. 220, N 6. P. 1467–1474. doi: 10.1016/j.amjsurg.2020.07.016

[17] Bagshaw SM, Stelfox HT, Iwashyna TJ, et al. Timing of onset of persistent critical illness: a multi-centre retrospective cohort study. Intensive Care Med. 2018;44(12):2134–2144. doi: 10.1007/s00134-018-5440-1

[18] Bagshaw S.M., Stelfox H.T., Iwashyna T.J., et al. Timing of onset of persistent critical illness: a multi-centre retrospective cohort study // Intensive Care Med. 2018. Vol. 44, N 12. P. 2134–2144. doi: 10.1007/s00134-018-5440-1

[19] Ohbe H, Matsui H, Fushimi K, Yasunaga H. Epidemiology of chronic critical illness in Japan: a nationwide inpatient database study. Crit Care Med. 2020;49(1):70–78. doi: 10.1097/CCM.0000000000004723

[20] Ohbe H., Matsui H., Fushimi K., Yasunaga H. Epidemiology of chronic critical illness in Japan: a nationwide inpatient database study // Crit Care Med. 2020. Vol. 49, N 1. P. 70–78. doi: 10.1097/CCM.0000000000004723

[21] Zingerenko VB. Modern concepts of metabolic disorders in critically ill patients. Problems of Nutrition. 2008;77(4):26–32. (In Russ).

[22] Зингеренко В.Б. Современные представления о нарушении обмена веществ у больных, находящихся в критических состояниях // Вопросы питания. 2008. Т. 77, № 4. С. 26–32.

[23] Brakenridge SC, Wang Z, Cox M, et al. Distinct immunologic endotypes are associated with clinical trajectory after severe blunt trauma and hemorrhagic shock. J Trauma Acute Care Surg. 2021;90(2):257–267. doi: 10.1097/TA.0000000000003029

[24] Brakenridge S.C., Wang Z., Cox M., et al. Distinct immunologic endotypes are associated with clinical trajectory after severe blunt trauma and hemorrhagic shock // J Trauma Acute Care Surg. 2021. Vol. 90, N 2. P. 257–267. doi: 10.1097/TA.0000000000003029

[25] Horn DL, Bettcher LF, Navarro SL, et al. Persistent metabolomic alterations characterize chronic critical illness after severe trauma. J Trauma Acute Care Surg. 2021;90(1):35–45. doi: 10.1097/TA.0000000000002952

[26] Horn D.L., Bettcher L.F., Navarro S.L., et al. Persistent metabolomic alterations characterize chronic critical illness after severe trauma // J Trauma Acute Care Surg. 2021. Vol. 9, N 1. P. 35–45. doi: 10.1097/TA.0000000000002952

[27] Darden DB, Brakenridge SC, Efron PA, et al. Biomarker Evidence of the Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS) in Chronic Critical Illness (CCI) After Surgical Sepsis. Ann Surg. 2021;274(4):664–673. doi: 10.1097/SLA.0000000000005067

[28] Darden D.B., Brakenridge S.C., Efron P.A., et al. Biomarker Evidence of the Persistent Inflammation, Immunosuppression and Catabolism Syndrome (PICS) in Chronic Critical Illness (CCI) After Surgical Sepsis // Ann Surg. 2021. Vol. 274, N 4. P. 664–673. doi: 10.1097/SLA.0000000000005067

[29] Marchioni A, Tonelli R, Sdanganelli A, et al. Prevalence and development of chronic critical illness in acute patients admitted to a respiratory intensive care setting. Pulmonology. 2020;26(3):151–158. doi: 10.1016/j.pulmoe.2019.09.006

[30] Marchioni A., Tonelli R., Sdanganelli A., et al. Prevalence and development of chronic critical illness in acute patients admitted to a respiratory intensive care setting // Pulmonology. 2020. Vol. 26, N 3. P. 151–158. doi: 10.1016/j.pulmoe.2019.09.006

[31] Brakenridge SC, Moore FA, Mercier NR, et al. Persistently elevated glucagon-like peptide-1 levels among critically ill surgical patients after sepsis and development of chronic critical illness and dismal long-term outcomes. J Am Coll Surg. 2019;229(1):58–67.e1. doi: 10.1016/j.jamcollsurg.2019.04.014

[32] Brakenridge S.C., Moore F.A., Mercier N.R., et al. Persistently elevated glucagon-like peptide-1 levels among critically ill surgical patients after sepsis and development of chronic critical illness and dismal long-term outcomes // J Am Coll Surg. 2019. Vol. 229, N 1. P. 58–67.e1. doi: 10.1016/j.jamcollsurg.2019.04.014

[33] Darden DB, Kelly LS, Fenner BP, et al. Dysregulated immunity and immunotherapy after sepsis. J Clin Med. 2021;10(8):1742. doi: 10.3390/jcm10081742

[34] Darden D.B., Kelly L.S., Fenner B.P., et al. Dysregulated immunity and immunotherapy after sepsis // J Clin Med. 2021. Vol. 10, N 8. P. 1742. doi: 10.3390/jcm10081742

[35] Mira JC, Cuschieri J, Ozrazgat-Baslanti T, et al. The epidemiology of chronic critical illness after severe traumatic injury at two level-one trauma centers. Crit Care Med. 2017;45(12):1989–1996. doi: 10.1097/CCM.0000000000002697

[36] Mira J.C., Cuschieri J., Ozrazgat-Baslanti T., et al. The epidemiology of chronic critical illness after severe traumatic injury at two level-one trauma centers // Crit Care Med. 2017. Vol. 45, N 12. P. 1989–1996. doi: 10.1097/CCM.0000000000002697

[37] Mira JC, Gentile LF, Mathias BJ, et al. Sepsis pathophysiology, chronic critical illness, and persistent inflammation-immunosuppression and catabolism syndrome. Crit Care Med. 2017; 45(2):253–262. doi: 10.1097/CCM.0000000000002074

[38] Mira J.C., Gentile L.F., Mathias B.J., et al. Sepsis pathophysiology, chronic critical illness, and persistent inflammation-immunosuppression and catabolism syndrome // Crit Care Med. 2017. Vol. 45, N 2. P. 253–262. doi: 10.1097/CCM.0000000000002074

[39] Darden DB, Ghita GL, Wang Z, et al. Chronic critical illness elicits a unique circulating leukocyte transcriptome in sepsis survivors. J Clin Med. 2021;10(15):3211. doi: 10.3390/jcm10153211

[40] Darden D.B., Ghita G.L., Wang Z., et al. Chronic critical illness elicits a unique circulating leukocyte transcriptome in sepsis survivors // J Clin Med. 2021. Vol. 10, N 15. P. 3211. doi: 10.3390/jcm10153211

[41] Lingling W, Rui C, Jiahui D, Zhenhui G. Predictive value of neutrophil to lymphocyte ratio in the progression of sepsis to chronic critical illness in elderly patients. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021;33(11):1291–1295. (In Chinese). doi: 10.3760/cma.j.cn121430-20210628-00952

[42] Lingling W., Rui C., Jiahui D., Zhenhui G. Predictive value of neutrophil to lymphocyte ratio in the progression of sepsis to chronic critical illness in elderly patients // Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2021. Vol. 33, N 11. P. 1291–1295. (In Chinese). doi: 10.3760/cma.j.cn121430-20210628-00952

[43] Rosenthal MD, Bala T, Wang Z, et al. Chronic critical illness patients fail to respond to current evidence-based intensive care nutrition secondarily to persistent inflammation, immunosuppression, and catabolic syndrome. JPEN J Parenter Enter Nutr. 2020;44(7): 1237–1249. doi: 10.1002/jpen.1794

[44] Rosenthal M.D., Bala T., Wang Z., et al. Chronic critical illness patients fail to respond to current evidence-based intensive care nutrition secondarily to persistent inflammation, immunosuppression, and catabolic syndrome // JPEN J Parenter Enter Nutr. 2020. Vol. 44, N 7. P. 1237–1249. doi: 10.1002/jpen.1794

[45] Petrova MV, Sergeev IV, Shestopalov AE, Lukyanets OV. Metabolic disorders of chronically critically ill patients caused by consequences of traumatic brain injury. Problems of Nutrition. 2021;90(4):103–111. (In Russ). doi: 10.33029/0042-8833-2021-90-4-103-111

[46] Петрова М.В., Сергеев И.В., Шестопалов А.Е., Лукьянец О.Б. Метаболические нарушения у пациентов, находящихся в хроническом критическом состоянии, обусловленном последствиями черепно-мозговой травмы // Вопросы питания. 2021. Т. 90, № 4. С. 103–111. doi: 10.33029/0042-8833-2021-90-4-103-111

[47] Rosenthal MD, Vanzant EL, Moore FA. Chronic critical illness and pics nutritional strategies. J Clin Med. 2021;10(11):2294. doi: 10.3390/jcm10112294

[48] Rosenthal M.D., Vanzant E.L., Moore F.A. Chronic critical illness and pics nutritional strategies // J Clin Med. 2021. Vol. 10, N 11. P. 2294. doi: 10.3390/jcm10112294

[49] Carson SS, Bach PB. The epidemiology and costs of chronic critical illness. Crit Care Clin. 2002;18(3):461–476. doi: 10.1016/s0749-0704(02)00015-5

[50] Carson S.S., Bach P.B. The epidemiology and costs of chronic critical illness // Crit Care Clin. 2002. Vol. 18, N 3. P. 461–476. doi: 10.1016/s0749-0704(02)00015-5

[51] Carson SS, Bach PB, Brzozowski L, Leff A. Outcomes after long-term acute care. An analysis of 133 mechanically ventilated patients. Am J Respir Crit Care Med. 1999;159(5 Pt 1):1568–1573. doi: 10.1164/ajrccm.159.5.9809002

[52] Carson S.S., Bach P.B., Brzozowski L., Leff A. Outcomes after long-term acute care. An analysis of 133 mechanically ventilated patients // Am J Respir Crit Care Med. 1999. Vol. 159, N 5–1. P. 1568–1573. doi: 10.1164/ajrccm.159.5.9809002

[53] Cox CE. Persistent systemic inflammation in chronic critical illness. Respir Care. 2012;57(6):859–864. doi: 10.4187/respcare.01719

[54] Cox C.E. Persistent systemic inflammation in chronic critical illness // Respir Care. 2012. Vol. 57, N 6. P. 859–864. doi: 10.4187/respcare.01719

[55] Cox CE, Martinu T, Sathy SJ, et al. Expectations and outcomes of prolonged mechanical ventilation. Crit Care Med. 2009;37(11): 2888–2894. doi: 10.1097/CCM.0b013e3181ab86ed

[56] Cox C.E., Martinu T., Sathy S.J., et al. Expectations and outcomes of prolonged mechanical ventilation // Crit Care Med. 2009. Vol. 37, N 11. P. 2888–2894. doi: 10.1097/CCM.0b013e3181ab86ed

[57] Cox CE, Docherty SL, Brandon DH, et al. Surviving critical illness: acute respiratory distress syndrome as experienced by patients and their caregivers. Crit Care Med. 2009;37(10):2702–278. doi: 10.1097/CCM.0b013e3181b6f64a

[58] Cox C.E., Docherty S.L., Brandon D.H., et al. Surviving critical illness: acute respiratory distress syndrome as experienced by patients and their caregivers // Crit Care Med. 2009. Vol. 37, N 10. P. 2702–278. doi: 10.1097/CCM.0b013e3181b6f64a

[59] Khan J, Bath K, Hafeez F, et al. Creatinine excretion as a determinant of accelerated skeletal muscle loss with critical illness. Turk J Anaesthesiol Reanim. 2018;46(4):311–315. doi: 10.5152/TJAR.2018.60437

[60] Khan J., Bath K., Hafeez F., et al. Creatinine excretion as a determinant of accelerated skeletal muscle loss with critical illness // Turk J Anaesthesiol Reanim. 2018. Vol. 46, N 4. P. 311–315. doi: 10.5152/TJAR.2018.60437

[61] Daly BJ, Rudy EB, Thompson KS, Happ MB. Development of a special care unit for chronically critically ill patients. Heart Lung. 1991;20(1):45–51.

[62] Daly B.J., Rudy E.B., Thompson K.S., Happ M.B. Development of a special care unit for chronically critically ill patients // Heart Lung. 1991. Vol. 20, N 1. P. 45–51.

[63] Daly BJ, Douglas SL, Kelley CG, et al. Trial of a disease management program to reduce hospital readmissions of the chronically critically ill. Chest. 2005;128(2):507–517. doi: 10.1378/chest.128.2.507

[64] Daly B.J., Douglas S.L., Kelley C.G., et al. Trial of a disease management program to reduce hospital readmissions of the chronically critically ill // Chest. 2005. Vol. 128, N 2. P. 507–517. doi: 10.1378/chest.128.2.507

[65] Douglas SL, Daly BJ, Kelley CG, et al. Impact of a disease management program upon caregivers of chronically critically ill patients. Chest. 2005;128(6):3925–3936. doi: 10.1378/chest.128.6.3925

[66] Douglas S.L., Daly B.J., Kelley C.G., et al. Impact of a disease management program upon caregivers of chronically critically ill patients // Chest. 2005. Vol. 128, N 6. P. 3925–3936. doi: 10.1378/chest.128.6.3925

[67] Hollander JM, Mechanick JI. Nutrition support and the chronic critical illness syndrome. Nutr Clin Pract. 2006;21(6):587–604. doi: 10.1177/0115426506021006587

[68] Hollander J.M., Mechanick J.I. Nutrition support and the chronic critical illness syndrome // Nutr Clin Pract. 2006. Vol. 21, N 6. P. 587–604. doi: 10.1177/0115426506021006587

[69] Macintyre NR. Chronic critical illness: the growing challenge to health care. Respir Care. 2012;57(6):1021–1027. doi: 10.4187/respcare.01768

[70] Macintyre N.R. Chronic critical illness: the growing challenge to health care // Respir Care. 2012. Vol. 57, N 6. P. 1021–1027. doi: 10.4187/respcare.01768

[71] MacIntyre NR, Epstein SK, Carson S, et al. National Association for Medical Direction of Respiratory C. Management of patients requiring prolonged mechanical ventilation: report of a NAMDRC consensus conference. Chest. 2005;128(6):3937–3954. doi: 10.1378/chest.128.6.3937

[72] MacIntyre N.R., Epstein S.K., Carson S., et al. National Association for Medical Direction of Respiratory C. Management of patients requiring prolonged mechanical ventilation: report of a NAMDRC consensus conference // Chest. 2005. Vol. 128, N 6. P. 3937–3954. doi: 10.1378/chest.128.6.3937

[73] McEwen BS. Stress, adaptation, and disease. Allostasis and allostatic load. Ann N Y Acad Sci. 1998;840:33–44. doi: 10.1111/j.1749-6632.1998.tb09546.x

[74] McEwen B.S. Stress, adaptation, and disease. Allostasis and allostatic load // Ann N Y Acad Sci. 1998. Vol. 840. P. 33–44. doi: 10.1111/j.1749-6632.1998.tb09546.x

[75] Schulman RC, Mechanick JI. Metabolic and nutrition support in the chronic critical illness syndrome. Respir Care. 2012;57(6): 958–977. doi: 10.4187/respcare.01620

[76] Schulman R.C., Mechanick J.I. Metabolic and nutrition support in the chronic critical illness syndrome // Respir Care. 2012. Vol. 57, N 6. P. 958–977. doi: 10.4187/respcare.01620

[77] Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19): 1359–1367. doi: 10.1056/NEJMoa011300

[78] Van den Berghe G., Wouters P., Weekers F., et al. Intensive insulin therapy in critically ill patients // N Engl J Med. 2001. Vol. 345, N 19. P. 1359–1367. doi: 10.1056/NEJMoa011300

[79] Mizock BA. Alterations in fuel metabolism in critical illness: hyperglycaemia. Best Pract Res Clin Endocrinol Metab. 2001; 15(4):533–535. doi: 10.1053/beem.2001.0168

[80] Mizock B.A. Alterations in fuel metabolism in critical illness: hyperglycaemia // Best Pract Res Clin Endocrinol Metab. 2001. Vol. 15, N 4. P. 533–535. doi: 10.1053/beem.2001.0168

[81] Gore DC, Chinkes D, Heggers J, et al. Association of hyperglycemia with increased mortality after severe burn injury. J Trauma. 2001; 51(3):540–544. doi: 10.1097/00005373-200109000-00021

[82] Gore D.C., Chinkes D., Heggers J., et al. Association of hyperglycemia with increased mortality after severe burn injury // J Trauma. 2001. Vol. 51, N 3. P. 540–544. doi: 10.1097/00005373-200109000-00021

[83] Rosenberg IH. Sarcopenia: origins and clinical relevance. J Nutr. 1997;127(Suppl. 5):990S–991S. doi: 10.1093/jn/127.5.990S

[84] Rosenberg I.H. Sarcopenia: origins and clinical relevance // J Nutr. 1997. Vol. 127, Suppl. 5. P. 990S–991S. doi: 10.1093/jn/127.5.990S

[85] Cruz-Jentoft AJ, Baeyens JP, Bauer M, et al. Sarcopenia: European consensus on definition and diagnosis — report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412–423. doi: 10.1093/ageing/afq034

[86] Cruz-Jentoft A.J., Baeyens J.P., Bauer M., et al. Sarcopenia: European consensus on definition and diagnosis — report of the European Working Group on Sarcopenia in Older People // Age Ageing. 2010. Vol. 39, N 4. P. 412–423. doi: 10.1093/ageing/afq034

[87] Cruz-Jentoft AJ, Landi F, Schneider SM, et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing. 2014;43(6):748–759. doi: 10.1093/ageing/afu115

[88] Cruz-Jentoft A.J., Landi F., Schneider S.M., et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS) // Age Ageing. 2014. Vol. 43, N 6. P. 748–759. doi: 10.1093/ageing/afu115

[89] Looijaard WGPM, Stapel SN, Dekker IM, et al. Identifying critically ill patients with low muscle mass: Agreement between bioelectrical impedance analysis and computed tomography. Clin Nutr. 2020;39(6):1809–1817. doi: 10.1016/j.clnu.2019.07.020

[90] Looijaard W.G.P.M., Stapel S.N., Dekker I.M., et al. Identifying critically ill patients with low muscle mass: Agreement between bioelectrical impedance analysis and computed tomography // Clin Nutr. 2020. Vol. 39, N 6. P. 1809–1817. doi: 10.1016/j.clnu.2019.07.020

[91] Janssen I, Heymsfield SB, Wang Z, Ross R. Skeletal muscle mass and distribution in 468 men and women aged 18-88 yr. J Appl Physiol (1985). 2000;89(1):81–88. doi: 10.1152/jappl.2000.89.1.81

[92] Janssen I., Heymsfield S.B., Wang Z., Ross R. Skeletal muscle mass and distribution in 468 men and women aged 18–88 yr // J Appl Physiol (1985). 2000. Vol. 8, N 1. P. 81–88. doi: 10.1152/jappl.2000.89.1.81

[93] Janssen I, Baumgartner RN, Ross R, et al. Skeletal muscle cutpoints associated with elevated physical disability in older men and women. Am J Epidemiol. 2004;159(4):413–421. doi: 10.1093/aje/kwh058

[94] Janssen I., Baumgartner R.N., Ross R., et al. Skeletal muscle cutpoints associated with elevated physical disability in older men and women // Am J Epidemiol. 2004. Vol. 159, N 4. P. 413–421. doi: 10.1093/aje/kwh058

[95] Cosqueric G, Sebag A, Ducolombier C, et al. Sarcopenia is predictive of nosocomial infection in care of the elderly. Br J Nutr. 2006;96(5):895–901. doi: 10.1017/bjn20061943

[96] Cosqueric G., Sebag A., Ducolombier C., et al. Sarcopenia is predictive of nosocomial infection in care of the elderly // Br J Nutr. 2006. Vol. 96, N 5. P. 895–901. doi: 10.1017/bjn20061943

[97] Krylov KYu, Grechko AV, Petrova MV, et al. Nutritional-metabolic therapy in chronically critical patients after cerebral accident: a manual for physicians. Moscow: Green Print; 2018. 40 p. (In Russ).

[98] Крылов К.Ю., Гречко А.В., Петрова М.В., и др. Нутритивно-метаболическая терапия у пациентов в хроническом критическом состоянии после церебральной катастрофы: пособие для врачей. Москва: Грин Принт, 2018. 40 с.

[99] Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48–79. doi: 10.1016/j.clnu.2018.08.037

[100] Singer P., Blaser A.R., Berger M.M., et al. ESPEN guideline on clinical nutrition in the intensive care unit // Clin Nutr. 2019. Vol. 38, N 1. P. 48–79. doi: 10.1016/j.clnu.2018.08.037

[101] Khubutia MSh, Popova TS, Saltanov AI, editors. Parenteral and enteral nutrition: national guidelines. Moscow: GEOTAR-Media; 2015. 793 p. (In Russ).

[102] Парентеральное и энтеральное питание: национальное руководство / под ред. М.Ш. Хубутия, Т.С. Поповой, А.И. Салтанова. Москва: ГЭОТАР-Медиа, 2015. 793 с.

[103] Luft VM, editor. Clinical Nutrition Guide. Saint Petersburg: Art-Express; 2016. 432 p. (In Russ).

[104] Руководство по клиническому питанию / под ред. В.М. Луфта. Санкт-Петербург: Арт-Экспресс, 2016. 432 с.

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Shestopalov A.E., Yakovleva A.V., Lukyanets O.B., Petrova M.V.