I read the article on malnutrition in hospital with great interest—I work in a hospital that has inpatients that have intentionally entered a state of malnutrition: patients with eating disorders such as bulimia or anorexia.
In order to assess the severity of the malnutrition, bioimpedance analysis has become the trusted standard in our hospital. By measuring body cell mass (BCM, metabolically active mass or muscle mass), body fat, and body water it is possible to ascertain the extent to which body fat reserves are depleted, whether the patient is in a catabolic state with compensatory water retention or whether they are acting in a manipulative, self harming manner. By means of this test we then decide systematically on the basis of a certain stepwise scheme (phase angle, ECM/BCM index) whether a protein-rich diet (Figure 2 Steps II or III in the article) is sufficient or whether parenteral nutrition (Figure 2 Steps V or VI in the article) is required.
Dr. med. Monika Gebel
Bad Mergentheim, Germany
|1.||Löser C: Malnutrition in hospital—the clinical and economic |
implications. Dtsch Arztebl Int 2010; 107(51–52): 911–7.