Prone position, time to reach nutrition target, and energy/protein achievement rate on the seventh day of intensive care unit stay in patients with COVID-19: A cohort study.

Autor: Richrot TS; Residence Multiprofessional Program: Intensive Care, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil., Lima J; Nutrition Science Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil., Stello BB; Department of Nutrition, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil., Milanez DSJ; Nutrition Science Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil., Burgel CF; Nutrition and Dietetics Service, Hospital Complex Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil., Silva FM; Residence Multiprofessional Program: Intensive Care, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.; Nutrition Science Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.; Nutrition Department, Nutrition Science Graduate Program and Residence Multiprofessional Program: Intensive Care, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil.
Jazyk: angličtina
Zdroj: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition [Nutr Clin Pract] 2023 Jun; Vol. 38 (3), pp. 609-616. Date of Electronic Publication: 2023 Jan 21.
DOI: 10.1002/ncp.10952
Abstrakt: Background: We aimed to evaluate the mean time to reach the energy (EAR) and protein (PAR) achievement rate among patients with coronavirus disease 2019 (COVID-19) who did or did not undergo prone position (PP) therapy in the first week of their stay in the intensive care unit (ICU), and the interaction of these nutrition therapy indicators on the association between PP and clinical outcomes.
Methods: This cohort study used retrospective data collected from medical records of patients with COVID-19 admitted to the ICU (≥18 years). We collected nutrition data, clinical information, prescription of PP, and its frequency during the first week, and clinical outcomes.
Results: PP therapy was administered to 75.2% of 153 patients (61.5 ± 14.8 years, 57.6% males) during the first week of their ICU stay. Patients who underwent PP reached nutrition therapy goals later (4 [3-6] vs 3 [2-4] days; P = 0.030) and had lower EAR (91.9 ± 25.7 vs 101.6 ± 84.0; P = 0.002) and PAR (88.0 ± 27.7 vs 98.1 ± 13.5; P = 0.009) in comparison to those who did not receive PP. Grouping patients who underwent PP according to the EAR (≥70% or <70%) did not show any differences in the incidence of ICU death, duration of mechanical ventilation, or ICU stay (P > 0.05).
Conclusions: In this exploratory study, PP was associated with a delayed time to reach the nutrition target and the lowest EAR and estimated protein requirement on the seventh day of ICU stay in patients with COVID-19. Permissive enteral nutrition prescription in patients who underwent PP was not associated with worse clinical outcomes.
(© 2023 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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