Cochrane COVID-19 Study Register
Cuerda 2020a

Nutritional treatment in critically ill patients with Covid-19 disease: from guidelines to clinical practise

  1. Study Type
  2. Observational
  1. Study Aim
  2. Not applicable
  1. Study Design
  2. Case series/Case control/Cohort
  1. Intervention Assignment
  2. Not Applicable

Nutritional treatment in critically ill patients with Covid-19 disease: from guidelines to clinical practise

Cuerda C, Velasco C, Miguelez M, Romero R, Carrasco P, Serrano C, Breton I, Motilla M, Arhip L, Morales A, Carrascal M, Rubio S, Calvo C, Camblor M
Rationale: Describe the experience of a tertiary hospital in the nutrition treatment and the adherence to clinical guidelines during the COVID-19 pandemic. Methods: Retrospective study including critically ill COVID-19 patients who needed medical nutrition treatment (MNT). Collected variables: sex, age, BMI, underlying diseases, type of respiratory support, caloric and protein requirements (25 kcal/kg adjusted body weight(ABW), 1.3 g/kg ABW/day), total calories (propofol), proteins administered at day 4th and 7th ICU admission, percentage of estimated calories and protein delivered at day 4th and 7th. Day of starting EN and PN. Adherence to ESPEN clinical guidelines (70% estimated calories at day 4th and 7th, 100 % estimated protein progressively in the first week, start EN in the 48h and PN in 3rd-7th day ICU admission). Variables: percentage and mean±SD. Results: One hundred and thirty-nine patients were included (74.8% men), 59.6±13.8 years, BMI 29.9±5.3 kg/m2. Comorbidities: 52.3% overweight, 38.6% obesity, 47.5% hypertension, 43.9% dyslipidaemia, 18.7% diabetes. 82.7% required mechanical ventilation (90.4% of them with pronation), 3.6% ECMO. Estimated caloric and protein requirements: 1773±252 kcal and 91.7±17 g. Table 1 presents delivered and % of delivered/estimated caloric and protein goal at day 4th and 7th, and adherence to ESPEN guidelines). PN was started at day 2.5±2.6 and EN at day 6±4.9 of admission (delayed in patients that needed pronation p<0.05). Only 16.6 % of patients started EN in the 48h, and 38.5% started PN in the 3rd-7th day of admission. [Formula presented] Conclusion: Only around one third of our patients received caloric and protein requirements according to ESPEN guidelines. In the rest of patients, both under and overfeeding were present. During this pandemic PN was used before EN in our centre, and it was associated with the pronation of the patients during the first week of ICU admission. References: Clinical Nutrition 38 (2019) 48-79 Disclosure of Interest: C. Cuerda: None declared, C. Velasco: None declared, M. Miguelez: None declared, R. Romero: None declared, P. Carrasco: None declared, C. Serrano: None declared, I. Breton: None declared, M. Motilla: None declared, L. Arhip Grant / Research Support from: Fresenius-Kabi, A. Morales: None declared, M. Carrascal: None declared, S. Rubio: None declared, C. Calvo: None declared, M. Camblor: None declared