Evaluating Nutritional Risk Factors for Delirium in Intensive-Care-Unit Patients: Present Insights and Prospects for Future Research

Author:

Piccirillo Arianna1,Perri Francesco2ORCID,Vittori Alessandro3ORCID,Ionna Franco1,Sabbatino Francesco4ORCID,Ottaiano Alessandro5ORCID,Cascella Marco6ORCID

Affiliation:

1. Otolaryngology and Maxillo-Facial Surgery Unit, Istituto Nazionale Tumori—IRCCS Fondazione G. Pascale, 80131 Naples, Italy

2. Medical and Experimental Head and Neck Oncology Unit, Istituto Nazionale Tumori—IRCCS Fondazione G. Pascale, 80131 Naples, Italy

3. Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy

4. Medical Oncology Department, University of Salerno, 84084 Fisciano, Italy

5. SSD Innovative Therapies for Abdominal Metastases, Abdominal Oncology, Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, 80131 Naples, Italy

6. Unit of Anesthesiology, Intensive Care Medicine, and Pain Medicine, Department of Medicine, Surgery, and Dentistry, University of Salerno, Via Salvador Allende, 43, 84081 Baronissi, Italy

Abstract

Malnutrition, hypercatabolism, and metabolic changes are well-established risk factors for delirium in critically ill patients. Although the exact mechanisms are not fully understood, there is mounting evidence suggesting that malnutrition can cause a variety of changes that contribute to delirium, such as electrolyte imbalances, immune dysfunction, and alterations in drug metabolism. Therefore, a comprehensive metabolic and malnutrition assessment, along with appropriate nutritional support, may help to prevent or ameliorate malnutrition, reduce hypercatabolism, and improve overall physiological function, ultimately lowering the risk of delirium. For this aim, bioelectrical impedance analysis can represent a valuable strategy. Further research into the underlying mechanisms and nutritional risk factors for delirium is crucial to developing more effective prevention strategies. Understanding these processes will allow clinicians to personalize treatment plans for individual patients, leading to improved outcomes and quality of life in the intensive-care-unit survivors.

Publisher

MDPI AG

Subject

General Medicine

Reference102 articles.

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3. Clinical Phenotypes of Delirium during Critical Illness and Severity of Subsequent Long-Term Cognitive Impairment: A Prospective Cohort Study;Girard;Lancet Respir. Med.,2018

4. Delirium in Hospitalized Older Adults;Marcantonio;N. Engl. J. Med.,2017

5. Motor Subtypes of Postoperative Delirium in Older Adults;Robinson;Arch. Surg.,2011

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