Background Hypermetabolism has been described in stress states such as trauma, sepsis, acute respiratory distress syndrome, and severe burn injuries. We hypothesize that patients with Coronavirus disease 2019 (COVID‐19) may develop a hypermetabolic state, which may be a major contributing factor to the extraordinary ventilatory and oxygenation demands in patients with COVID‐19. Method Resting energy expenditure (REE), carbon dioxide production (VCO2), and oxygen consumption (VO2) were measured by indirect calorimetry on 7 critically ill patients with COVID‐19. Results The median measured REE was 4044 kcal/d, which was 235.7% ± 51.7% of predicted. The median VCO2 was 452 mL/min (range, 295–582 mL/min), and the median VO2 was 585 mL/min (range, 416–798 mL/min). Conclusion Critically ill patients with COVID‐19 are in an extreme hypermetabolic state. This may explain the high failure rates for mechanical ventilation for these patients and highlights the potential need for increased nutrition requirements for such patients.
Background We have observed that critically ill patients with COVID-19 are in an extreme hypermetabolic state. This may be a major contributing factor to the extraordinary ventilatory and oxygenation demands seen in these patients. We aimed to quantify the extent of the hypermetabolic state and report the clinical effect of the use of hypothermia to decrease the metabolic demand in these patients. Methods Mild hypothermia was applied on four critically ill patients with COVID-19 for 48 h. Metabolic rates, carbon dioxide production and oxygen consumption were measured by indirect calorimetry. Results The average resting energy expenditure (REE) was 299% of predicted. Mild hypothermia decreased the REE on average of 27.0% with resultant declines in CO 2 production (VCO 2 ) and oxygen consumption (VO 2 ) by 29.2% and 25.7%, respectively. This decrease in VCO 2 and VO 2 was clinically manifested as improvements in hypercapnia (average of 19.1% decrease in pCO 2 levels) and oxygenation (average of 50.4% increase in pO 2 ). Conclusion Our case series demonstrates the extent of hypermetabolism in COVID-19 critical illness and suggests that mild hypothermia reduces the metabolic rate, improves hypercapnia and hypoxia in critically ill patients with COVID-19.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.