Biomarkers in critical care nutrition

Crit Care. 2020 Aug 12;24(1):499. doi: 10.1186/s13054-020-03208-7.


The goal of nutrition support is to provide the substrates required to match the bioenergetic needs of the patient and promote the net synthesis of macromolecules required for the preservation of lean mass, organ function, and immunity. Contemporary observational studies have exposed the pervasive undernutrition of critically ill patients and its association with adverse clinical outcomes. The intuitive hypothesis is that optimization of nutrition delivery should improve ICU clinical outcomes. It is therefore surprising that multiple large randomized controlled trials have failed to demonstrate the clinical benefit of restoring or maximizing nutrient intake. This may be in part due to the absence of biological markers that identify patients who are most likely to benefit from nutrition interventions and that monitor the effects of nutrition support. Here, we discuss the need for practical risk stratification tools in critical care nutrition, a proposed rationale for targeted biomarker development, and potential approaches that can be adopted for biomarker identification and validation in the field.

Keywords: Biomarker; Critical care; Metabolism; Nutrition.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Albumins / analysis
  • Biomarkers / analysis*
  • Biomarkers / blood
  • Body Composition / physiology
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Critical Care / methods
  • Critical Care / statistics & numerical data
  • Enteral Nutrition / adverse effects
  • Enteral Nutrition / methods
  • Enteral Nutrition / standards
  • Humans
  • Insulin Resistance / physiology
  • Interleukin-6 / analysis
  • Interleukin-6 / blood
  • Nitrogen / analysis
  • Nitrogen / blood
  • Nutrition Therapy / adverse effects
  • Nutrition Therapy / methods
  • Nutrition Therapy / standards*
  • Nutritional Support / adverse effects
  • Nutritional Support / methods
  • Nutritional Support / standards
  • Parenteral Nutrition / adverse effects
  • Parenteral Nutrition / methods
  • Parenteral Nutrition / standards
  • Proteins / analysis


  • Albumins
  • Biomarkers
  • IL6 protein, human
  • Interleukin-6
  • Proteins
  • C-Reactive Protein
  • Nitrogen