Acute illness results in a severe catabolic state with marked proteolysis and loss of lean body mass. Loss of lean body mass has profound consequences, resulting in marked functional disability and increasing the risk of falls, bone fractures, and generalized frailty. The consequences of acute illness on functional outcomes are best illustrated by the study of Herridge and colleagues,1 who followed 109 patients who had survived acute respiratory distress syndrome. In their study, patients had lost 18% of their baseline body weight by the time they were discharged, and all complained of weakness and fatigue; at 12 months, the distance walked in 6 minutes was 66% of that predicted. Furthermore, after 5 years of follow-up, functional ability had not improved over values at 1 year.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Marik PE. Nutritional Support Among Medical Inpatients—Feed the Cold (and Malnourished) and Starve the Febrile. JAMA Netw Open. 2019;2(11):e1915707. doi:https://doi.org/10.1001/jamanetworkopen.2019.15707
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: