Protein-energy malnutrition and sarcopenia in acute cerebral insufficiency

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.