Georgia Hardy1, Luigi Camporota2, Danielle E Bear3. 1. Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, London UK; Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London UK. 2. Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London UK. 3. Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, London UK; Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London UK. Electronic address: Danielle.Bear@gstt.nhs.uk.
Abstract
BACKGROUND & AIMS: Critically ill patients with COVID-19 are at high nutrition risk. This study aimed to describe the nutrition support practices in a single centre critical care unit during the initial surge of the COVID-19 pandemic. Practices were explored from ICU admission to post-ICU follow-up clinic and patients who received veno-venous extra-corporeal membrane oxygenation (VV-ECMO) were compared to those who did not. METHODS: This retrospective observational study included COVID-19 positive, adult ICU patients who were mechanically ventilated for ≥72 h. Data were collected from ICU admission until the time of post-ICU clinic. For in-ICU data, results are compared between patients who did and did not receive VV-ECMO. RESULTS: 252 patients were included (VV-ECMO n = 58). Adequate energy and protein was delivered in 193 (76.6%) patients during their ICU admission with no differences between those who did and did not receive VV-ECMO (44 (75.9%) vs. 149 (76.8%)). Parenteral nutrition only being required in 12 (4.8%) patients. Following stepdown to the ward 77 (70%) patients required ongoing enteral nutrition support, and 74 (66.7%) required a texture modified diet or were NBM. Following hospital discharge, nearly a third of ICU survivors (28.4%) were referred for dietetic input. The most common referral reason was loss of weight. Breathlessness and fatigue were the most commonly reported nutrition impact symptoms experienced following hospital discharge. CONCLUSION: Results show it is possible to reach nutritional adequacy for most patients and that neither VV-ECMO nor proning were barriers to nutritional adequacy. Nutritional issues for patients who were critically ill with COVID-19 persist following stepdown to ward level and into the community and strategies to manage this require further investigation. Crown
BACKGROUND & AIMS: Critically ill patients with COVID-19 are at high nutrition risk. This study aimed to describe the nutrition support practices in a single centre critical care unit during the initial surge of the COVID-19 pandemic. Practices were explored from ICU admission to post-ICU follow-up clinic and patients who received veno-venous extra-corporeal membrane oxygenation (VV-ECMO) were compared to those who did not. METHODS: This retrospective observational study included COVID-19 positive, adult ICU patients who were mechanically ventilated for ≥72 h. Data were collected from ICU admission until the time of post-ICU clinic. For in-ICU data, results are compared between patients who did and did not receive VV-ECMO. RESULTS: 252 patients were included (VV-ECMO n = 58). Adequate energy and protein was delivered in 193 (76.6%) patients during their ICU admission with no differences between those who did and did not receive VV-ECMO (44 (75.9%) vs. 149 (76.8%)). Parenteral nutrition only being required in 12 (4.8%) patients. Following stepdown to the ward 77 (70%) patients required ongoing enteral nutrition support, and 74 (66.7%) required a texture modified diet or were NBM. Following hospital discharge, nearly a third of ICU survivors (28.4%) were referred for dietetic input. The most common referral reason was loss of weight. Breathlessness and fatigue were the most commonly reported nutrition impact symptoms experienced following hospital discharge. CONCLUSION: Results show it is possible to reach nutritional adequacy for most patients and that neither VV-ECMO nor proning were barriers to nutritional adequacy. Nutritional issues for patients who were critically ill with COVID-19 persist following stepdown to ward level and into the community and strategies to manage this require further investigation. Crown
Authors: Liisa MacGowan; Elizabeth Smith; Charmaine Elliott-Hammond; Barnaby Sanderson; Dennis Ong; Kathleen Daly; Nicholas A Barrett; Kevin Whelan; Danielle E Bear Journal: Clin Nutr Date: 2018-02-15 Impact factor: 7.324
Authors: Yaseen M Arabi; Elie Azoulay; Hasan M Al-Dorzi; Jason Phua; Jorge Salluh; Alexandra Binnie; Carol Hodgson; Derek C Angus; Maurizio Cecconi; Bin Du; Rob Fowler; Charles D Gomersall; Peter Horby; Nicole P Juffermans; Jozef Kesecioglu; Ruth M Kleinpell; Flavia R Machado; Greg S Martin; Geert Meyfroidt; Andrew Rhodes; Kathryn Rowan; Jean-François Timsit; Jean-Louis Vincent; Giuseppe Citerio Journal: Intensive Care Med Date: 2021-02-22 Impact factor: 17.440
Authors: Gerald Chanques; Jean-Michel Constantin; John W Devlin; E Wesley Ely; Gilles L Fraser; Céline Gélinas; Timothy D Girard; Claude Guérin; Matthieu Jabaudon; Samir Jaber; Sangeeta Mehta; Thomas Langer; Michael J Murray; Pratik Pandharipande; Bhakti Patel; Jean-François Payen; Kathleen Puntillo; Bram Rochwerg; Yahya Shehabi; Thomas Strøm; Hanne Tanghus Olsen; John P Kress Journal: Intensive Care Med Date: 2020-11-10 Impact factor: 17.440