Nutrition evaluation and management of critically ill patients with COVID-19 during post-intensive care rehabilitation.

Autor: Hoyois A; Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Ballarin A; CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Thomas J; CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Lheureux O; Departments of Intensive Care, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Preiser JC; Departments of Intensive Care, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Coppens E; Department of Radiology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Perez-Bogerd S; Department of Pneumology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Taton O; Department of Pneumology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Farine S; Dietetic Department, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Van Ouytsel P; Dietetic Department, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium., Arvanitakis M; Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Jazyk: angličtina
Zdroj: JPEN. Journal of parenteral and enteral nutrition [JPEN J Parenter Enteral Nutr] 2021 Aug; Vol. 45 (6), pp. 1153-1163. Date of Electronic Publication: 2021 Apr 30.
DOI: 10.1002/jpen.2101
Abstrakt: Background: Among hospitalized patients with coronavirus disease 2019 (COVID-19), up to 12% may require intensive care unit (ICU) management. The aim of this prospective cohort study is to assess nutrition status and outcome in patients with COVID-19 following ICU discharge.
Methods: Patients requiring a minimum of 14 days' stay in the ICU with mechanical ventilation were included. Nutrition status was assessed at inclusion (ICU discharge) and follow-up (after 15, 30, and 60 days). All patients had standardized medical nutrition therapy with defined targets regarding energy (30 kcal/kg/d) and protein intake (1.5 g/kg/d).
Results: Fifteen patients were included (67% males); the median age was 60 (33-75) years old. Body mass index at ICU admission was 25.7 (IQR, 24-31) kg/m². After a median ICU stay of 33 (IQR, 26-39) days, malnutrition was present in all patients (11.3% median weight loss and/or low muscle mass based on handgrip strength measurement). Because of postintubation dysphagia in 60% of patients, enteral nutrition was administered (57% nasogastric tube; 43% percutaneous endoscopic gastrostomy). After 2 months, a significant improvement in muscle strength was observed (median handgrip strength, 64.7% [IQR, 51%-73%] of the predicted values for age vs 19% [IQR, 4.8%-28.4%] at ICU discharge [P < 0.0005]), as well as weight gain of 4.3 kg (IQR, 2.7-6.7 kg) (P < 0.0002).
Conclusions: Critically ill patients with COVID-19 requiring ICU admission and mechanical ventilation have malnutrition and low muscle mass at ICU discharge. Nutrition parameters improve during rehabilitation with standardized medical nutrition therapy.
(© 2021 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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