Nutritional management of patients affected by SARS-CoV-2 admitted in the ICU according to a new specific protocol. An observational study

ABSTRACT

Introduction: The acute patient affected by SARS-CoV-2 infection presents an acute respiratory distress syndrome (ARDS) requiring respiratory and hemodynamic support in the intensive care unit (ICU) for at least 48 hours. Due to these circumstances, these patients require further nutritional care and are more likely to suffer malnutrition and other issues associated with it. On the basis of the above, the early nutritional care management of these patients must be integrated into the therapeutic strategy. These patients might benefit from a nutritional protocol specific for ICU patients. Objective: To describe if patients affected by SARS-CoV-2 admitted in the ICU of the Consorcio Hospital General Universitario from Valencia (CHGUV) during the pandemic period from March to May 2020 reached the nutritional requirements according to our specific protocol. Methods: Observational, descriptive, and retrospective study to describe our results and our experience with a specific nutritional protocol created for patients affected by SARS-CoV-2 admitted in the ICU of the CHGUV. Results: A sample of 31 patients was included. A nutritional follow-up cannot be established in eight patients. The remaining patients, 8 reached 80% of their caloric requirements before the tenth day of admission in ICU and 10 after the eleventh day. Five patients did not reach the nutritional requirements at any time. On average, early enteral nutrition starts before day 4. Moreover, 79% of patients received additional protein supply and 17% received complimentary parenteral nutrition. Conclusion: In our study, we realized that the pandemic situation provoked more difficulties to accomplish the nutritional standards in patients affected by COVID 19. Moreover, these patients need muscular relaxation and prone positions making it more difficult to achieve the nutritional objectives. Finally, it is really important to create and adapt our protocols to these patients in order to improve our results.