Cachexia
OVERVIEW
- Cachexia refers to weight loss and skeletal muscle wasting due to illness where the body does not reduce catabolism (unlike the adaptive reduction in protein metabolism that occurs in starvation)
- Mechanisms not clearly understood
PREDISPOSING FACTORS
- Pre-existing malnutrition / malabsorption
- Cytokine-induced up-regulation of muscle protein degradation
- Neuro-endocrine – stimulation of hypothalamic-pituitary-adrenal axis
- Reduced circulating anabolic hormones
- Immobility and prolonged length of stay
- Corticosteroid therapy
- Malignancy
CONSEQUENCES
- Increased risk of death
- Prolonged time on ventilator
- Increased ICU and hospital length of stay
- Increased risk of nosocomial infections
- Poor wound healing
- Weakness and slow respiratory weaning
- Malnutrition and nutritional deficiency syndromes
References and Links
- Gordon JN, Green SR, Goggin PM. Cancer cachexia. QJM. 2005 Nov;98(11):779-88. PMID: 16214835.
- Morley JE, Thomas DR, Wilson MM. Cachexia: pathophysiology and clinical relevance. Am J Clin Nutr. 2006 Apr;83(4):735-43. PMID: 16600922.
- von Haehling S, Doehner W, Anker SD. Nutrition, metabolism, and the complex pathophysiology of cachexia in chronic heart failure. Cardiovasc Res. 2007 Jan 15;73(2):298-309.PMID: 17034772.
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC