Protein requirements for critically ill ventilator-dependent patients with COVID-19.
Nutr Clin Pract
; 36(5): 984-992, 2021 Oct.
Article
in English
| MEDLINE | ID: covidwho-1380401
ABSTRACT
BACKGROUND:
Recent studies indicate critically ill patients with coronavirus disease 2019 (COVID-19) are hypermetabolic; however, protein requirements in critically ill COVID-19 patients are unknown. Our intent was to evaluate the nitrogen accretion response to varying protein intakes for critically ill ventilator-dependent patients with COVID-19.METHODS:
Adult patients (age ≥ 18 years) with COVID-19, admitted to the intensive care unit (ICU) and who required mechanical ventilation were retrospectively evaluated. Patients received continuous enteral nutrition (EN), including supplemental protein boluses, and had a 24-h urine collection for determination of nitrogen balance (NBAL). Data are expressed as mean ± SD with a P-value < .05 as significant.RESULTS:
Twenty-two patients provided 29 NBAL determinations. Protein intake from EN and protein supplements was 0.9 ± 0.7 g/kg/day at the time of the NBAL with an NBAL of -12.1 ± 10.9 g/day at 7 ± 4 days in the ICU. Combined caloric intake from EN and propofol at the time of the NBAL was 12 ± 8 kcal/kg/day. Nitrogen equilibrium (NBAL of -4 g/day or better) occurred in five patients. Patients achieving nitrogen equilibrium received more protein than those with a negative NBAL (1.2 ± 0.4 g/kg/day vs 0.8 ± 0.8 g/kg/day, P = .046). The linear regression for NBAL in response to graded increases in protein intake was as follows NBAL = 8.5 × protein intake (g/kg/day) - 18.8 (r = 0.450, P < .001).CONCLUSION:
Critically ill ventilator-dependent patients with COVID-19 exhibit significant variability in nitrogen accretion response to increases in protein intake and often have a markedly negative NBAL.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Critical Illness
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
Limits:
Adolescent
/
Adult
/
Humans
Language:
English
Journal:
Nutr Clin Pract
Journal subject:
Nutritional Sciences
/
Nursing
Year:
2021
Document Type:
Article
Affiliation country:
Ncp.10763
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