Easy-to-prescribe nutrition support in the intensive care in the era of COVID-19

Autor: Jérôme Pugin, Aude de Watteville, Gleicy Keli Barcelos, Claude Pichard, Laurence Genton, Claudia Paula Heidegger
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
0301 basic medicine
Dieticians
Endocrinology
Diabetes and Metabolism
0302 clinical medicine
Surveys and Questionnaires
SD
Standard deviation
Medicine
Medical nutrition therapy
ddc:616
Response rate (survey)
Nutrition and Dietetics
ddc:617
Nutritional Support
IC
Indirect calorimetry
ICU
Intensive care unit
Intensive Care Units
Prescriptions
Original Article
PN
Parenteral nutrition
Female
Medical emergency
Coronavirus Infections
Switzerland
SPN
Supplemental parenteral nutrition
Critical Care
Attitude of Health Personnel
Critical Illness
Pneumonia
Viral
030209 endocrinology & metabolism
Context (language use)
BMI
Body mass index
ESPEN
European society for clinical nutrition and metabolism
Clinical nutrition
Betacoronavirus
Nutrition therapy
03 medical and health sciences
Intensive care
ARDS
Acute respiratory distress syndrome
Humans
Medical prescription
Pandemics
Protocol (science)
030109 nutrition & dietetics
Pandemic
SARS-CoV-2
Questionnaire
business.industry
EN
Enteral nutrition
COVID-19
medicine.disease
BW
Body weight
ICU
Critical illness
business
Zdroj: Clinical Nutrition ESPEN
Clinical nutrition ESPEN, Vol. 39 (2020) pp. 74-78
Clinical Nutrition Espen
ISSN: 2405-4577
DOI: 10.1016/j.clnesp.2020.07.015
Popis: Background & aims: COVID-19 pandemic had resulted in a massive increase in the number of patients admitted to intensive care units (ICUs). This created significant organizational challenges including numerous non-specialist ICU caregivers who came to work in the ICU. In this context, pragmatic protocols were essential to simplify nutritional care. We aimed at providing a simple and easy-to-prescribe nutritional protocol and evaluated its usefulness with questionnaires sent to physicians involved in the care of ICU COVID-19 patients.Methods: A simplified nutrition protocol was distributed to all physicians (n = 122) of the ICU medical team during COVID-19 pandemic. Clinical dieticians estimated energy targets for acute and post-acute phases at patient's admission and suggested adaptations of nutrition therapy. More complex situations were discussed with clinical nutrition doctors and, if required, a clinical evaluation was performed. To further facilitate the procedure, a chart with prescription aids was also distributed to the whole medical ICU team. At the end of the current pandemic wave, a 13-item questionnaire was emailed to the ICU medical team to obtain their opinion on the suggested nutritional therapy.Results: Answers were received from 81/122 medical doctors (MDs) (66% response rate), from intensive care physicians (41%), anaesthesiologists (53%) and MDs from other specialties (6%). Thirty-two percent of MDs felt that their knowledge of nutrition management was insufficient and 45% of the physicians surveyed did not face nutrition management in their daily practice prior to the pandemic. The initially proposed nutritional protocol, the chart with prescription aids and the suggested nutritional proposals were considered as useful to very useful by the majority of physicians surveyed (89.9, 90.7 and 92.1% respectively). The protocol was followed by 92% of MDs, and almost all participants (95%) were convinced that adaptations of nutritional therapy had beneficial effects on patients' outcomes.Conclusions: Nutritional therapy in critically ill COVID-19 patients is a challenge and the implementation of this specific pandemic simplified nutritional protocol was assessed as useful by a great majority of physicians. Pragmatic and simplified protocols are useful for ensuring the quality of nutritional therapy and could be used in future studies to assess its actual impact on the clinical outcomes of COVID-19 patients.
Databáze: OpenAIRE
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