ABSTRACT
Medical nutrition should be tailored to cover a patient's needs, taking into account medical and organizational possibilities and obstacles. This observational study aimed to assess calories and protein delivery in critically ill patients with COVID-19. The study group comprised 72 subjects hospitalized in the intensive care unit (ICU) during the second and third SARS-CoV-2 waves in Poland. The caloric demand was calculated using the Harris–Benedict equation (HB), the Mifflin–St Jeor equation (MsJ), and the formula recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN). Protein demand was calculated using ESPEN guidelines. Total daily calorie and protein intakes were collected during the first week of the ICU stay. The median coverages of the basal metabolic rate (BMR) during day 4 and day 7 of the ICU stay reached: 72% and 69% (HB), 74% and 76% (MsJ), and 73% and 71% (ESPEN), respectively. The median fulfillment of recommended protein intake was 40% on day 4 and 43% on day 7. The type of respiratory support influenced nutrition delivery. A need for ventilation in the prone position was the main difficulty to guarantee proper nutritional support. Systemic organizational improvement is needed to fulfill nutritional recommendations in this clinical scenario.
ABSTRACT
Medical nutrition should be tailored to cover a patient's needs, taking into account medical and organizational possibilities and obstacles. This observational study aimed to assess calories and protein delivery in critically ill patients with COVID-19. The study group comprised 72 subjects hospitalized in the intensive care unit (ICU) during the second and third SARS-CoV-2 waves in Poland. The caloric demand was calculated using the Harris-Benedict equation (HB), the Mifflin-St Jeor equation (MsJ), and the formula recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN). Protein demand was calculated using ESPEN guidelines. Total daily calorie and protein intakes were collected during the first week of the ICU stay. The median coverages of the basal metabolic rate (BMR) during day 4 and day 7 of the ICU stay reached: 72% and 69% (HB), 74% and 76% (MsJ), and 73% and 71% (ESPEN), respectively. The median fulfillment of recommended protein intake was 40% on day 4 and 43% on day 7. The type of respiratory support influenced nutrition delivery. A need for ventilation in the prone position was the main difficulty to guarantee proper nutritional support. Systemic organizational improvement is needed to fulfill nutritional recommendations in this clinical scenario.
Subject(s)
COVID-19 , Humans , Critical Illness/therapy , SARS-CoV-2 , Nutritional Support , Nutritional Status , ProteinsABSTRACT
Intensive technology development as well as the COVID-19 pandemic has contributed to the increased interest in the telemedicine and mHealth sector. Increasing availability and use of mobile devices as well as the constantly growing number of nutritional mobile applications, resulted in creating new tools for food and meals nutrients calculation which can be used by patients with diabetes. Variety of mobile applications and multiple functions included in them enable finding applications focused on individual patients' needs. The scientific data coming from research conducted so far suggest that the regular use of mobile nutritional applications contributes to improving metabolic control of diabetes and the reduction of the value of glycated hemoglobin in patients with diabetes. Innovative solutions bring hope also for a significant improvement in the quality of life of patients. The aim of this article was to summarize the EBM knowledge about the use of mHealth in self-control and diet of patients with diabetes, especially type 1 and to present and assess the nutrition mobile applications available in polish language according to their functionality in diabetic self-control.