Vol 2, No 1 (2021)


Venous access for parenteral nutrition: Changes in Europe and North America over the past 12 years

Kurmukov I.A., Obukhova O.A.


This article provides an overview of the significant changes in clinical practices since the publication of the European Association for Clinical Nutrition and Metabolism guidelines on providing vascular access for parenteral nutrition regarding the choice of vascular access and prevention and treatment of the most common and important complications of long-term venous access, the catheter-associated bloodstream infection, and internal lumen obstruction of catheters.

The preferred vascular access for parenteral nutrition for medium- to long-term parenteral nutrition is the tunneled central venous catheter, peripherally inserted central catheter, or a fully implantable port system, which is now largely determined by the underlying disease, near-term prognosis and patient comfort, and short-term parenteral nutrition in a hospital that largely depends on the capabilities of a particular medical institution. Strict adherence to modern standard measures for infection control and care of venous access and infusion lines, hand hygiene, and appropriate training of medical personnel, patients, and their caregivers are currently the most reliable and effective methods to prevent catheter-associated bloodstream infection. Taurolidine “catheter lock” is used as an additional measure.

In most cases, the occlusion of the inner canal of the catheter can be eliminated by drug methods; however, its effectiveness directly depends on the correspondence of the chosen drug to the cause of the occlusion. Generally, changes in recent years have significantly reduced the incidence and risk of parenteral nutrition complications associated with vascular access.

Clinical nutrition and metabolism. 2021;2(1):5-12
pages 5-12 views

Sarcopenia and its diagnosis

Zakrevsky A.I., Fedorova A.A., Pasechnik I.N., Kutepov D.E.


An increased life expectancy is associated with an increased number of persons suffering from sarcopenia, as manifested by a loss of muscle mass, strength, and body functions (decreased performance) due to aging processes.

The development of sarcopenia significantly reduces the quality of life of patients and worsens the results of treatment in the event of life-threatening conditions. Unfortunately, clinicians underestimate its diagnosis and do not pay enough attention to the muscle conditions, as well as the prevention and treatment of sarcopenia.

To date, active research and search for methods for diagnosing sarcopenia and similar pathological conditions of the muscle tissue (cachexia, fatty infiltration, and inflammatory lesions of muscle tissue) are conducted. Various scales are used to detect sarcopenia at the prehospital stage. An example is the Strength, Assistance with Walking, Rising from a Chair, Climbing Stairs, and Falls questionnaire that assess the following indicators: lifting a load, walking around the room, getting out of bed, climbing the stairs, and involuntary falls. The use of scales is limited in a hospital setting; thus, instrumental diagnostic methods are more informative, particularly bioimpedance, dual-energy X-ray absorptiometry, computed tomography, and magnetic resonance imaging, but the most in demand is ultrasound imaging of the muscle tissue.

The dynamics of the severity of sarcopenia is a promising method used to assess nutritional support and rehabilitation measures in patients under intensive care.

Clinical nutrition and metabolism. 2021;2(1):13-22
pages 13-22 views

Phase angle: medical interpretations and applications

Nikolaev D.V., Shchelykalina S.P.


Specialists are interested in using bioimpedance technology to assess the rate of metabolic processes and body composition; thus, this study aimed to determine the possibilities of the clinical application of the phase angle, which is a parameter that is specific for the bioimpedance method to obtain body composition information. In nutrition assessment, the phase angle is used as an indirect characteristic of the protein fraction of the body and the rate of metabolic processes.

In the early 2000s, low values of the phase angle in diseased catabolic orientation were shown to assess the survival rate whereas high values assess the muscular system fitness in athletes and other individuals who regularly experience physical exertion. Systematic reviews and Meta-analyzes of subsequent years have summarized the evidence based on these provisions and identified several new applications for sarcopenia, anorexia, and renal failure. Therefore, all the reviews presented in this study confirm that higher phase angle values correspond to a better state of the body and that phase angle can dynamically change in an individual patient. This feature of the parameter requires a detailed understanding of the variability of values depending on measurement conditions.

The phase angle is recognized as a convenient diagnostic tool and a convenient parameter for screening examinations. At high values, it reflects the degree of muscular system fitness, and at low values, the severity of catabolic disorders due to existing diseases or immobilization.

Clinical nutrition and metabolism. 2021;2(1):23-36
pages 23-36 views

Screening methods for the nutritional status assessment in young children with an intestinal infection

Erpuleva Y.V., Rumiantsev R.E.


The nutritional status assessment in young children with infectious diseases is an important and necessary measure in the practice of a pediatrician.

Nutrition is an important component of therapeutic measures for various childhood diseases from the time of illness; a child may have difficulty eating and not receive an age-appropriate amount of nutrients. Untimely nutritional support harms the course of the disease and can lead to the development of nutritional deficiency.

The highest risk of developing nutritional status disorders exists in children with acute intestinal infections. Patients have dyspeptic symptoms (nausea, vomiting, and diarrhea), which makes the natural consumption of food difficult. Specialized enteral nutrition in acute intestinal infections plays an important role — it restores the balanced nutritional status of a sick child, maintains the intestinal microbiota, and reduces the duration of intestinal infections.

This article describes the modern principles of screening assessment of nutritional status in young children with intestinal infections. The main laboratory markers are shown (concentration of albumin, transthyretin, transferrin, and the total number of circulating lymphocytes) in which the changes may indicate the risk of developing nutritional deficiency and a more severe course of the disease. In an infectious hospital, screening methods to assess nutritional status can be used to timely detect eating disorders, such as the method for assessing the risk of malnutrition (STRONGkids), screening for malnutrition in pediatrics (STAMP), and the universal screening scale for malnutrition (MUST).

Different scales and tools are used for screening; thus, further research is needed to determine the most optimal method of nutritional status assessment in young children with infectious pathology.

Clinical nutrition and metabolism. 2021;2(1):37-43
pages 37-43 views


Professor Igor V. Prianikov (08.04.1959-12.03.2021)

Petrova M.V., Luginina E.V.


On March 12, 2021, at 62 years of age, a member of the editorial colleague of the journal “Clinical Nutrition and Metabolism”, a professor and a doctor of medical sciences — Igor Valentinovich Pryanikov — suddenly passed away.

Igor Valentinovich made an invaluable contribution to the development of intensive care and medical rehabilitation of patients with the consequences of serious diseases, injuries and lesions of the central nervous system, the organization of a state system of measures aimed at reducing disability and mortality rates in the Russian Federation.

Clinical nutrition and metabolism. 2021;2(1):44-46
pages 44-46 views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies