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12Th KEPAN CONGRESS ABSTRACTS DOI: 10.5152/ClinSciNutr.2021.080321 12th KEPAN CONGRESS ABSTRACTS Selected Abstracts for Oral Presentation NUTRITION 12th KEPAN CONGRESS ABSTRACTS SS01 Predictive Effect of a New Screening Tool for Nutritional Risk in Neonatal Intensive Care Unit Nadir Yalçın1, Hasan Tolga Çelik2, Kutay Demirkan1, Şule Yiğit2 1Hacettepe University, Faculty of Pharmacy, Department of Clinical Pharmacy, Ankara, Turkey 2Hacettepe University, Faculty of Medicine, Neonatology Unit, Department of Child Health and Diseases, Ankara, Turkey Objective: Hospitalized newborns are at increased risk of malnutrition and especially preterm infants often experience postnatal growth failure.1 It was aimed to evaluate the predictive effect of malnutrition risk on the initiation of parenteral nutrition (PN) and length of stay (LOS) while patients were admitted to neonatal intensive care unit (NICU) within 24 hours. Methods: Neonatal Nutritional Screening Tool (NNST) was prospectively applied to all infants in the NICU within 24 hours of their hospitalization. The predictive effects of NNST and birth weight on LOS and PN administration were evaluated with Poisson regres- sion analysis. The study protocol was approved by the local Ethics Committee. Results: Total of 303 patients with a mean gestational age of 35 weeks and 2 days and a mean birth weight of 2552 g were prospec- tively included in the study. According to the NNST, 27 (8.9%) of the patients had a high risk, 70 (23.1%) had a moderate risk, and 206 (68.0%) had a low nutritional risk. However, PN treatment was initiated in 118 (38.9%) of the patients. Even though, the mean LOS was 14 days for all patients, LOS was 2.7 times higher in patients with a high nutritional risk compared to patients with a low nutritional risk (p<0.001). In addition, probability of PN administration was 4.9 times higher in patients with a high nutritional risk compared to patients with a low nutritional risk (p=0.003). Conclusion: NNST is a current, simple and practical tool that should be considered by clinicians in terms of predicting PN initiation and LOS for neonates. Keywords: Neonatal intensive care unit, malnutrition risk, parenteral nutrition, length of stay Reference 1. Johnson MJ, Pearson F, Emm A, et al. Developing a new screening tool for nutritional risk in neonatal intensive care. Acta Paediatr 2015; 104: e90-3. SS02 A New Method in Estimating Muscle Mass in Sarcopenic Obesity: Ultrasonographic Muscle Measurement Adjusted with Body Mass Index Olgun Deniz1, Zeynep Kahyaoğlu2, Merve Güner Oytun2, Arzu Okyar Baş2, Çağatay Çavuşoğlu2, Burcu Balam Doğu2, Mustafa Cankurtaran2, Meltem Halil2 1Bursa City Hospital, Palliative Care Unit, Internal Medicine and Geriatrics, Bursa, Turkey 2Hacettepe University Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey Objective: Sarcopenic obesity is the coexistence of sarcopenia and obesity in an individual. However, its definition and diagnosis are debated. Ultrasonography, which has been widely used in muscle evaluation in sarcopenia, has also been started to be used in sarcopenic obesity. In this study, we aimed to investigate the importance of ultrasonographic muscle measurements adjusted with body mass index (BMI) to diagnose sarcopenic obesity. Methods: 145 community-dwelling older participants with a body mass index of 30 and above were included in this study. Com- prehensive geriatric assessment evaluating cognition, nutrition, mood, and functional status of the patients, as well as handgrip strength (HGS) and bioimpedance analysis (BIA), was performed. In six different types of muscle [gastrocinemius medialis (GM), rectus femoris (RF), rectus abdominis (RA), external abdominal oblique (EAO), internal abdominal oblique(IAO), transversus ab- dominis (TA)] ultra-sonographic evaluation of the patients was carried out. The results were noted by dividing the muscle mea- surements by the BMI of the patients. Sarcopenic obesity was diagnosed as low muscle strength (male<27 kg, female<16 kg) with a BMI ≥ of 30. Results: The median age of the patients was 72 (65-89) and 82% (n=119) were women. Patients with sarcopenic obesity were older and had lower physical functionality. While anthropometric measurements (waist and hip circumference, BMI) related to obesity, and estimated muscle mass measurement obtained from bioimpedance analysis were similar in both groups, anthropometric parameters estimating muscle mass (calf circumference, middle-upper arm circumference) were lower in patients with sarcopenic obesity. All ul- S1 12th KEPAN CONGRESS ABSTRACTS trasonographic muscle measurements adjusted with BMI were lower in the sarcopenic obese group, while the statistically significant measurement was found to be the cross-sectional area (CSA) of ​​the rectus femoris (RF) muscle [0.12 (0.05-0.24) versus 0.15 (0.06- 0.31), p=0.01]. Receiver operating characteristic (ROC) analysis suggested that the optimum cut-off point of BMI adjusted RF CSA for sarcopenic obesity was ≤ 0.128 cm2 with 65.12% sensitivity, 67.95% specificity (AUC: 0.643). Conclusion: Ultrasonographic muscle measurement by adjusting the body mass index, especially for rectus femoris muscle, an easy, non-invasive, radiation-free, cheap, and easily portable method, may be used for sarcopenic obesity muscle assessment. SS03 Evaluation of Gastrointestinal Failure with Gastric Ultrasound and I-FABP, Citrulline in Intensive Care Sevda Onuk1, Tuğra Özer Özer2, Merve Özel3, Hilal Sipahioğlu1, Güven Kahriman4, Gülden Başkol3, Kürşat Gündoğan5, Aynur Akın6 1Kayseri State Hospital, Intensive Care, Kayseri, Turkey 2Department of Clinical Nutrition, Erciyes University, Health Sciences Institute, Kayseri, Turkey 3Department of Medical Biochemistry, Erciyes University, Faculty of Medicine, Kayseri, Turkey 4Department of Radiology, Erciyes University, Faculty of Medicine, Kayseri, Turkey 5Internal Diseases Intensive Care Unit, Erciyes University, Faculty of Medicine, Kayseri, Turkey 6Anesthesia Intensive Care Unit, Erciyes University, Faculty of Medicine, Kayseri, Turkey Objective: Gastrointestinal (GI) failure is associated with intensive care stay and mortality. Currently, there is no single method that can reliably define gastrointestinal dysfunction. In this study, we aimed to evaluate critically ill patients hospitalized in the intensive care unit in terms of gastrointestinal failure by gastric ultrasonography and by measuring I-FABP and citrulline levels after initiating enteral feeding. Methods: This study was carried out prospectively in Erciyes University Intensive Care Units. Patients between the ages of 18-80 years, who stayed in the intensive care unit for more than 48 hours and were fed with nasogastric or nasoduodenal tube, were in- cluded in the study. Anteroposterior (AP) and craniocaudal (CC) diameters of the patients were measured by ultrasonography and the gastric antral cross sectional area (CSA) was calculated with the following formula. CSA=3,142 x (mean AP diameter x mean CC diameter)/4 Then, GRV was evaluated with aspiration method. These measurements were made on the 24th hour, 3rd day and 5th day after the patients started feeding. At the same time, I-FABP and citrulline levels were measured by ELISA method. Results: 39 patients were included in this study. The patients were divided into two groups according to their gastrointestinal symp- toms as those with and without GI failure. The mean age was 56±20 years. The most common reasons for admission to intensive care were respiratory failure (18) and sepsis/septic shock (9). The mean APACHE II score of the patients was 21±6. The duration of stay in the intensive care unit was 15.0 (4.0-95.0) days, and the number of days on mechanical ventilation was 14.0 (0-70.0). There was no difference in I-FABP and citrulline levels at 24th hour, 3rd day and 5th day in the groups with and without GI failure. In the measure- ments made by ultrasonography, AP diameter was greater in those with GI failure at 24th hour (p<0.05). There was no correlation between I-FABP and citrulline and AP and CC diameters. Conclusion: In this study, it was concluded that I-FABP and citrulline levels are not useful in demonstrating GI failure, but AP mea- surement performed at 24th hour by ultrasonography can be used to determine GI failure. Keywords: Gastrointestinal failure, gastric ultrasound, I-FABP, citrulline Table (Continued) Main variables Variables Total GI failure Non-GI failure p IFABp Baseline 5.19 (3.23-204.40) 11.2 (3.63-204.40) 4.3 (3.23-94.56) 0.107 3rd day 6.44 (3.21-199.27) 5.52 (3.68-199.27) 6.54 (3.21-195.76) 1.000 5th day 4.93 (3.12-208.11) 4.37 (3.60-150.06) 6.02 (3.12-208.11) 0.302 Citrulline Baseline 6.35 (4.54-392.74) 9.19 (4.94-395.69) 6.17 (4.54-109.74) 0.478 3rd day 9.11(4.54-392.74) 18.07 (4.99-385.93) 5.94 (4.54-392.74) 0.194 5th day 9.36 (4.49-371.74) 6.61 (4.89-344.47) 11.63 (4.49-371.74) 0.685 S2 12th KEPAN CONGRESS ABSTRACTS Table (Continued) CC 24th hour 28.53±10.79 32.78±10.82 25.70±10.23 0.155 3rd day 30.45±9.64 31.48±8.08 29.84±10.85 0.753 5th day 34.04±6.49 35.75±2.34 31.77±10.22 0.473 AP 24th hour 18.54±8.21 23.12±7.56 15.49±7.39 0.038 3rd day 22.55±11.54 22.08±8.57 22.83±13.44 0.905 5th day 18.47±3.90 19.68±7.80 16.87±2.11 0.395 CSA 24th hour 4.87±3.01 5.81±3.83 4.11±2.07 0.286 3rd day 5.34±2.97 5.63±3.20 5.17±2.99 0.776 5th day 3.84±2.05 4.86±1.21 4.51±2.11 0.147 SS04 Associations of Sarcopenic Obesity versus Sarcopenia Alone with Functionality Gulistan Bahat1, Cihan Kılıç1, Serdar Özkök1, Savaş Öztürk2, Mehmet Akif Karan1 1İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, İstanbul, Turkey 2İstanbul University, İstanbul Faculty of Medicine, Department of Internal Medicine, İstanbul, Turkey Objective: There have been several attempts to come up with a global operational definition of sarcopenia (S), and consequently, a definition of S has been established, to some extent.
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