Background: Patients with critical illness may present with disease‐related malnutrition upon intensive care unit (ICU) admission. They are at risk of development and progression of malnutrition over the disease trajectory because of inflammation, dysregulated metabolism, and challenges with feeding.Methods: The Global Leadership Initiative on Malnutrition (GLIM) convened a panel of 36 clinical nutrition experts to develop consensus‐based guidance statements addressing the diagnosis of malnutrition during critical illness using a modified Delphi approach with a requirement of ≥75% agreement.Results: (1) To identify pre‐existing malnutrition, we suggest evaluation within 48 h of ICU admission when feasible (100% agreement) or within 4 days (94% agreement). (2) To identify the development and progression of malnutrition, we suggest re‐evaluation of all patients every 7–10 days (97% agreement). (3) To identify progressive loss of muscle mass, we suggest evaluation of muscle mass as soon as feasible (92% agreement) and again after 7–10 days (89% agreement). (4) To identify the development and progression of malnutrition before and after ICU discharge, we suggest re‐evaluating nutrition status before ICU discharge and during clinical visits that follow (100% agreement).Conclusion: Research using consistent etiologic and phenotypic variables offers great potential to assess the efficacy of nutrition interventions for critically ill patients with malnutrition. Assessment of these variables during and beyond the ICU stay will clarify the trajectory of malnutrition and enable exploration of impactful treatment modalities at each juncture. GLIM offers a diagnostic approach that can be used to identify malnutrition in critically ill patients.

Patients with critical illness may present with disease-related malnutrition upon intensive care unit (ICU) admission. They are at risk of development and progression of malnutrition over the disease trajectory because of inflammation, dysregulated metabolism, and challenges with feeding. The Global Leadership Initiative on Malnutrition (GLIM) convened a panel of 36 clinical nutrition experts to develop consensus-based guidance statements addressing the diagnosis of malnutrition during critical illness, using a modified Delphi approach with a requirement of ≥75% agreement. CONCLUSION: Research using consistent etiologic and phenotypic variables offers great potential to assess the efficacy of nutrition interventions for critically ill patients with malnutrition. Assessment of these variables at during and beyond the ICU stay will clarify the trajectory of malnutrition and enable exploration of impactful treatment modalities at each juncture. GLIM offers a diagnostic approach that can be used to identify malnutrition in critically ill patients.

Amaç: Bu çalışma, santral venöz kateter bakımında kullanılan yöntemlerin santral venöz kateter ilişkili enfeksiyona etkisini belirlemek amacı ile sistematik bir şekilde gerçekleştirilmiştir. Gereç ve Yöntem: Bu sistematik derlemede; “Google Scholar, Pubmed, Science Direct, Proquest, Cochrane Library, ULAKBİM, EBSCOhost ve Google Akademik olmak üzeri 8 veri tabanından ulaşılabilen, 1 Ocak 2007-15 Aralık 2017 tarihleri arasında yapılan araştırmalar incelenmiştir. Çalışmada Türkçe ve İngilize olarak “bakım”, “santral venöz kateter”, “enfeksiyon”, “kateter ilişkili enfeksiyon”, “kateterizasyon” anahtar kelimeleri kullanılmıştır. Bu bağlamda; araştırmaya dahil edilme kriterlerine uyan ulusal ve uluslararası çalışmalar taranmış olup, 40 yayın çalışma kapsamında değerlendirilmiştir. Bulgular: Sistematik derlemeye dahil edilen araştırmaların 11’i prospektif, 8’i randomize kontrollü deneysel, 5’i retrospektif, 3’ü gözlemsel, 3’ü tanımlayıcı, 3’ü yarı deneysel, 2’si prospektif randomize kontrollü deneysel, diğerleri ise prospektif-gözlemsel-girişimsel-kesintili zaman serileri, metodolojik, kesitsel, tek gruplu ön test-son test yarı deneysel, retrospektif-yarı deneysel araştırma tasarımına sahiptir. Elde edilen araştırma sonuçlarına göre %2, %4 klorheksidin, povidon iyot, oktenidin hidrokloritinin deri antisepsisinde kullanıldığı; katater yerleştirme ve bakımına ilişkin bakım paketlerinin kullanıldığı; klorheksidin glukonat emdirilmiş sünger sargı, poliüretan şeffaf film örtü, gazlı bez ve mikro gözenekli bantların santral venöz kateter pansumanında; klorheksidinin hasta banyosunda kullanıldığı tespit edilmiştir. Sonuç: Klorheksidin solüsyonunun deri antisepsisinde ve hasta banyosunda kullanılmasının, klorheksidin emdirilmiş sünger sargıların ve şeffaf film örtülerin kateter alanının kapatılmasında kullanılmasının kateter ilişkili enfeksiyon insidansını düşürebileceği sonucuna varılmıştır. Ayrıca hastalara, çeşitli disiplinler tarafından oluşturulan santral venöz kateter bakım paketlerinin uygulanmasının etkili hemşirelik bakım uygulamaları arasında olduğu ve kateter ilişkili enfeksiyonun önlenmesinde yararlı olabileceği düşünülmektedir.

Background: Intensive Care Units (ICUs) provide critical support for patients after major surgery or acute abdominal conditions. Despite medical advances, mortality remains high in surgical ICU patients. This study aimed to identify clinical and biochemical predictors of mortality in surgical patients admitted to a tertiary ICU. Methods: We conducted a retrospective case–control study on 231 adult general surgery patients admitted to a tertiary anesthesia ICU between January 2018 and December 2023. Patients under 18 years or who underwent solid organ transplantation were excluded. Data collected included demographic, clinical, and laboratory parameters such as the Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score, neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (CRP)/albumin ratio. Patients were divided into mortality and survival groups, with subgroup analyses performed for malignancy, sepsis, and trauma. Receiver operating characteristic (ROC) curve and Cox regression analyses were used to identify mortality predictors. Results: The ICU mortality rate was 64.9%. Significant predictors included age ≥ 58 years (odds ratio [OR] 4.56), body mass index (BMI) > 30 kg/m² (OR 7.62), mean arterial pressure < 70 mmHg (OR 1.66), serum albumin < 21.3 g/L (OR 1.5), APACHE II > 18.5 (OR 2.42), and SOFA > 9.5 (OR 2.68). Mortality was also associated with lower GCS scores, prolonged mechanical ventilation, and inotropic support. The CRP/albumin ratio was significantly elevated in the mortality group (p = 0.024). Other inflammatory markers showed no significant differences. Predictive factors varied among subgroups. Conclusions: Older age, obesity, hypotension, hypoalbuminemia, and high severity scores independently predict mortality in surgical ICU patients. Early risk identification may enhance management and improve outcomes in this population.