Nutritional treatment in critically ill patients with COVID-19 disease: spanish experience in a university hospital

C. Cuerda, C. Velasco, M. Miguélez, R. Romero,P. Carrasco,C. Serrano, I. Bretón, M. Motilla,L. Arhip,Ariel Marcel Tarazona Morales, M.L. Carrascal,S. Rubio,C. Calvo,M. Camblor

Clinical nutrition ESPEN(2020)

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摘要
Rationale: Patients with COVID-19 disease develop respiratory insufficiency, 5% of which needs ICU treatment Describe the experience of a tertiary hospital in the nutrition treatment, during this pandemic and the adherence to clinical guidelines Methods: Retrospective study including COVID-19 patients from 3 ICU units of our hospital that needed medical nutrition treatment (MNT) Collected variables: sex, age, BMI, underlying diseases, time from hospitalisation to ICU admission, type of respiratory support, 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), mortality Variables are expressed as percentage and mean±SD Statistics: IBM-SPSS26v Results: Forty-nine patients were included (78% men), 63 1±11 8 years, BMI 29 1±5 1 kg/m2 Comorbidities: 53% overweight, 28 5% obesity, 61 2% hypertension, 49% dyslipidaemia, 20 4% diabetes 98% required mechanical ventilation (98% pronation) Hospitalisation to ICU admission time: 3 2±3 4 days 71% EN, 98% PN, 69% mixed EN+PN Caloric and protein requirements: 1747±201 kcal and 91 7±10 g Table 1 presents total and % of caloric and protein goal at day 4th and 7th 59 2% and 10 2% patients had low levels of P and Mg in the first week, 81 6% hyperglycaemia, 8 2% hypoglycaemia, 95% hypertriglyceridemia (23%>500 mg/dl), 34 7% AKF and 16 3% KRT, 49% mortality [Formula presented] Conclusion: Most of our patients reached estimated caloric and protein target at day 4th and 7th of ICU PN was necessary in most of our sample in the first week to reach nutritional requirements We observed a high rate of metabolic complications which requires close monitoring of nutritional treatment 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 L Carrascal: None declared, S Rubio: None declared, C Calvo: None declared, M Camblor: None declared
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