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Energy expenditure and feeding practices and tolerance during the acute and late phase of critically ill COVID-19 patients.
Lakenman, P L M; van der Hoven, B; Schuijs, J M; Eveleens, R D; van Bommel, J; Olieman, J F; Joosten, K F M.
  • Lakenman PLM; Division of Dietetics, Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: p.lakenman@erasmusmc.nl.
  • van der Hoven B; Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: b.vanderhoven.1@erasmusmc.nl.
  • Schuijs JM; Division of Dietetics, Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
  • Eveleens RD; Intensive Care Unit, Department of Paediatrics and Paediatric Surgery, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands.
  • van Bommel J; Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
  • Olieman JF; Division of Dietetics, Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
  • Joosten KFM; Intensive Care Unit, Department of Paediatrics and Paediatric Surgery, Erasmus Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands.
Clin Nutr ESPEN ; 43: 383-389, 2021 06.
Article in English | MEDLINE | ID: covidwho-1163553
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
3. Calorimetr MEASURES C0014272
Subject
Calorimetr
Predicate
MEASURES
Object
C0014272
4. Energy Metabolism PROCESS_OF Phasis
Subject
Energy Metabolism
Predicate
PROCESS_OF
Object
Phasis
5. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
6. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
7. Calorimetry, Indirect MEASURES Energy Metabolism
Subject
Calorimetry, Indirect
Predicate
MEASURES
Object
Energy Metabolism
8. Energy Metabolism PROCESS_OF Phasis
Subject
Energy Metabolism
Predicate
PROCESS_OF
Object
Phasis
ABSTRACT
BACKGROUND &

AIMS:

Different metabolic phases can be distinguished in critical illness, which influences nutritional treatment. Achieving optimal nutritional treatment during these phases in critically ill patients is challenging. COVID-19 patients seem particularly difficult to feed due to gastrointestinal problems. Our aim was to describe measured resting energy expenditure (mREE) and feeding practices and tolerance during the acute and late phases of critical illness in COVID-19 patients.

METHODS:

Observational study including critically ill mechanically ventilated adult COVID-19 patients. Indirect calorimetry (Q-NRG+, Cosmed) was used to determine mREE during the acute (day 0-7) and late phase (>day 7) of critical illness. Data on nutritional intake, feeding tolerance and urinary nitrogen loss were collected simultaneously. A paired sample t-test was performed for mREE in both phases.

RESULTS:

We enrolled 21 patients with a median age of 59 years [44-66], 67% male and median BMI of 31.5 kg/m2 [25.7-37.8]. Patients were predominantly fed with EN in both phases. No significant difference in mREE was observed between phases (p = 0.529). Sixty-five percent of the patients were hypermetabolic in both phases. Median delivery of energy as percentage of mREE was higher in the late phase (94%) compared to the acute phase (70%) (p = 0.001). Urinary nitrogen losses were significant higher in the late phase (p = 0.003).

CONCLUSION:

In both the acute and late phase, the majority of the patients were hypermetabolic and fed enterally. In the acute phase patients were fed hypocaloric whereas in the late phase this was almost normocaloric, conform ESPEN guidelines. No significant difference in mREE was observed between phases. Hypermetabolism in both phases in conjunction with an increasing loss of urinary nitrogen may indicate that COVID-19 patients remain in a prolonged acute, catabolic phase.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / Enteral Nutrition / Energy Metabolism / COVID-19 / Nutritional Requirements Type of study: Etiology study / Clinical Practice Guide / Health economic evaluation Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Clin Nutr ESPEN Year: 2021 Document Type: Article

Full text: Available Collection: International databases Database: MEDLINE Main subject: Critical Illness / Enteral Nutrition / Energy Metabolism / COVID-19 / Nutritional Requirements Type of study: Etiology study / Clinical Practice Guide / Health economic evaluation Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Clin Nutr ESPEN Year: 2021 Document Type: Article