CICM SAQ 2011.2 Q2
Question
Define cachexia. List the factors that may predispose to cachexia AND the consequences of cachexia in a ventilated patient with sepsis and multi-organ dysfunction syndrome.
Answer
Answer and interpretation
Define Cachexia
- 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)
Predisposing factors
- Mechanisms not clearly understood
- 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
- Malnutrition and nutritional deficiency syndromes
Examination Library
CICM
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