1. Nutritional management and clinical outcome of critically ill patients with COVID-19: A retrospective study in a tertiary hospital
- Author
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Miguélez M, Velasco C, Camblor Álvarez, Miguel, Cedeño J, Serrano C, Bretón Lesmes, Irene, Arhip L, Motilla M, Carrascal ML, Olivares P, Morales A, Brox N, Cuerda Compes, María Cristina, Miguélez M, Velasco C, Camblor Álvarez, Miguel, Cedeño J, Serrano C, Bretón Lesmes, Irene, Arhip L, Motilla M, Carrascal ML, Olivares P, Morales A, Brox N, and Cuerda Compes, María Cristina
- Abstract
Background & aims: Severe COVID-19 infection is characterized by an inflammatory response and lung injury that can evolve into an acute respiratory distress syndrome that needs support treatment in intensive care unit. Nutritional treatment is an important component of the management of critically ill patients and should be started in the first 48 h of ICU admission to avoid malnutrition. This study describes the characteristics of the patients treated in a tertiary hospital in Madrid during the months of March-May 2020 (first wave), the medical nutrition treatment employed and its influence in the clinical outcome of these patients. Methods: This is a retrospective study including COVID-19 patients admitted in ICU that needed medical nutrition treatment (MNT). Collected variables included sex, age, BMI, underlying diseases, time from hospitalisation to ICU admission, type of respiratory support (invasive mechanical ventilation (IMV) or high flow nasal cannula (HFNC) or non-invasive ventilation (non-IMV)), caloric and protein requirements (25 kcal/kg adjusted body weight (ABW), 1.3 g/kg ABW/day), MNT type (enteral nutrition (EN), parenteral nutrition (PN), mixed EN + PN), total calories (including propofol) and proteins administered, percentage of caloric and protein goal in ICU day 4th and 7th, metabolic complications, acute kidney failure (AKF), length of stay (LOS) and mortality. Data are expressed as mean ± SD, median (IQR) or frequencies. Statistical analysis was performed with the IBM SPSS Statistics for Windows, Version 25.0. p < 0.05 were considered statistically significant. Results: A total of 176 patients were included (72.7% male), 60.1 ± 13.5 years, BMI 29.9 ± 5.4 kg/m2. Underlying diseases included 47.4% overweight, 39.8% obesity, 49.1% hypertension, 41.4% dyslipidaemia. 88.6% of patients needed IMV, 89.1% prone position, 2.9% ECMO. Time to ICU admission: 2 (4.75) days. Estimated caloric and protein requirements were 1775 ± 202 kcal and 92.4 ± 10.3 g., Depto. de Medicina, Fac. de Medicina, Universidad Complutense de Madrid, TRUE, pub
- Published
- 2024