Nutrition artificielle : l'exemple de la réanimation

Biomarkers for nutritional assessment and follow-up are in the first place two serum proteins, albumin and transthyretin, rather a prognosis marker for the first and a follow-up marker for the second, widely available in biology labs. The assessment of protein status may rely, for its easiest part, on the monitoring of nitrogen balance, preferably based on the measurement of total urinary nitrogen, but which will give only a static view of nitrogen metabolism; for laboratories with chromatographic equipment the determination of amino acids in blood (phenylalanine/tyrosine ratio) and urine (3-methyl-histidine) will provide information on the intensity of protein catabolism. Finally, the study of the complete plasma amino acid profile could be a promising tool for the individualized adaptation of nutritional support.