Clinical nutrition and metabolismClinical nutrition and metabolismКлиническое питание и метаболизм2658-44332782-2974Eco-Vector64336010.17816/clinutr643360ReviewsНаучные обзорыReview ArticleProtein-energy malnutrition and sarcopenia in acute cerebral insufficiencyБелково-энергетическая недостаточность и саркопения при острой церебральной недостаточности (обзор)https://orcid.org/0009-0002-6757-53891592-4884DobryninAleksey S.ДобрынинАлексей Сергеевич
Russian Federation
aleksey.dobrynin.Or@yandex.ruOrenburg State Medical UniversityОренбургский государственный медицинский университет14032025140320245251582312202430012025Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://journals.eco-vector.com/2658-4433/article/view/643360

This review addresses the issue of protein-energy malnutrition and sarcopenia in patients with acute cerebral insufficiency admitted to intensive care units. Acute cerebral insufficiency is defined as a symptom complex characterized by various quantitative and qualitative disturbances of consciousness, disrupted coordination between afferent and efferent central nervous system activities. This leads to temporary or persistent impairment of physical or social functioning. Patients with acute cerebral insufficiency are of particular interest in terms of protein-energy malnutrition and sarcopenia, as diagnosing these conditions can be challenging due to pre-existing neurological deficits and prolonged intensive care unit stays common in this population. Additionally, factors such as population aging and increasing median age of intensive care unit patients increase the significance of protein-energy malnutrition and sarcopenia. Global data indicate that over half of intensive care unit patients are 65 years and older, with the fastest-growing subgroup comprising patients over 85 years old, who are often admitted in the intensive care unit already suffering from protein-energy malnutrition and sarcopenia or having an extremely high risk for their development. The increasing prominence of protein-energy malnutrition and sarcopenia in intensive care unit settings raises numerous questions about clinical interpretation and the best approaches to diagnosis, monitoring, and treatment of patients with acute cerebral insufficiency that meet the protein-energy malnutrition and sarcopenia criteria.

В литературном обзоре рассматривается проблема белково-энерегетической недостаточности (БЭН) и саркопении у пациентов с острой церебральной недостаточностью (ОЦН) в отделении реанимации и интенсивной терапии (ОРИТ). ОЦН — это симптомокомплекс различных нарушений количественного и качественного уровня сознания, координированной активности афферентных и эфферентных систем центральной нервной системы, ведущих к временному или стойкому нарушению биологического или социального статуса больного. Пациенты с ОЦН представляют наибольший интерес в контексте развития БЭН и саркопении, так как их верификация затруднительна из-за исходного неврологического дефицита и пролонгированного пребывания этой категории пациентов в ОРИТ. Кроме того, такие факторы, как старение населения и увеличение среднего возраста пациентов в ОРИТ, актуализируют проблему БЭН и саркопении. Мировая практика показывает, что возраст более половины всех пациентов в ОРИТ — 65 лет и старше, причём наиболее быстрорастущая группа — пациенты в возрастной категории старше 85 лет, которые зачастую поступают в ОРИТ уже с имеющимися БЭН и саркопенией или с крайне высоким риском их развития. В связи с ростом актуальности проблемы БЭН и саркопении в ОРИТ возникает множество вопросов о клинической интерпретации и подходах к их диагностике, мониторингу и лечению больных, которые соответствуют критериям БЭН и саркопении при наличии ОЦН.

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