How could we make nutrition in the intensive care unit simple?

Singer, Pierre; Cohen, Jonathan

doi:10.5935/0103-507x.20160070

Cited by 8 publications

(11 citation statements)

References 18 publications

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“…In addition, during hospital stay, the prolonged immobilization, mainly in long stays in intensive care units (ICU), leads to muscle mass losses, making the recovery of these subjects harder. Furthermore, the need for assisted breathing during prolonged periods also contributes to the development of sarcopenia and malnutrition [84][85][86][87][88]. This deteriorated nutritional status seems to be involved in the virulence of the virus, and probably in the clinical outcome.…”

Section: Protein-energy Malnutritionmentioning

confidence: 99%

Key Aspects in Nutritional Management of COVID-19 Patients

Fernández‐Quintela

Milton-Laskíbar

Trepiana

et al. 2020

JCM

111

112

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This review deals with the relationship among nutrition, the immune system, and coronavirus disease 2019 (COVID-19). The influence of nutrients and bioactive molecules present in foodstuffs on immune system activity, the influence of COVID-19 on the nutritional status of the patients, and the dietary recommendations for hospitalized patients are addressed. Deficient nutritional status is probably due to anorexia, nausea, vomiting, diarrhea, hypoalbuminemia, hypermetabolism, and excessive nitrogen loss. There is limited knowledge regarding the nutritional support during hospital stay of COVID-19 patients. However, nutritional therapy appears as first-line treatment and should be implemented into standard practice. Optimal intake of all nutrients, mainly those playing crucial roles in immune system, should be assured through a diverse and well-balanced diet. Nevertheless, in order to reduce the risk and consequences of infections, the intakes for some micronutrients may exceed the recommended dietary allowances since infections and other stressors can reduce micronutrient status. In the case of critically ill patients, recently published guidelines are available for their nutritional management. Further, several natural bioactive compounds interact with the angiotensin-converting enzyme 2 (ACE2) receptor, the gateway for severe acute respiratory syndrome (SARS) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Natural bioactive compounds can also reduce the inflammatory response induced by SARS-CoV-2. These compounds are potential beneficial tools in the nutritional management of COVID-19 patients.

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Section: Protein-energy Malnutritionmentioning

confidence: 99%

Key Aspects in Nutritional Management of COVID-19 Patients

Fernández‐Quintela

Milton-Laskíbar

Trepiana

et al. 2020

JCM

111

112

View full text Add to dashboard Cite

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“…(17,19,22,23) The results regarding inadequate protein intake demonstrate the difficulty of achieving the proposed nutritional targets, which may lead to increased hospital malnutrition, increased complications and worsening of the clinical outcome, which was also demonstrated in this study. (1,5)…”

Section: Discussionmentioning

confidence: 99%

“…The priority in the nutritional therapy of these patients should be protein intake, and enteral formulas should thus be selected according to their protein content to obtain the recommended amount, which is 1.2 to 2g/kg/day. (5) However, some factors may interfere with adequate enteral nutrition, such as late onset of nutritional therapy, frequent surgeries and procedures and the presence of postoperative ileus, among others. (2)…”

Section: Introductionmentioning

confidence: 99%

Impact of protein intake and nutritional status on the clinical outcome of critically ill patients

Santos¹,

Araujo²

2019

Revista Brasileira De Terapia Intensiva

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Objective To evaluate the association of nutritional status and protein intake with the clinical outcomes of critically ill patients receiving enteral nutrition therapy in an intensive care unit. Methods A retrospective observational analytical study was performed by collecting secondary data recorded in medical records of patients ≥ 18 years of age who were admitted to the intensive care unit and who received exclusive enteral nutrition therapy for at least 72 hours in 2017. Nutritional status was assessed by body mass index and arm circumference. For the estimation of protein requirements, the recommendation of the American Society for Parenteral and Enteral Nutrition was considered. Nutritional adequacy was assessed by the daily collection of prescribed and administered enteral formula. In the analyses, parametric and nonparametric tests were used, and significance was set at p <0.05. Results Of the 188 patients evaluated, 71.3% were male. The median age of the patients was 48.5 years (31.0 - 63.75). The main clinical diagnosis was trauma (46.3%), and eutrophic was the most frequent nutritional status (54.8% according to body mass index and 46.4% according to arm circumference). Protein adequacy was not attained in 56.4% of patients, and only 46.8% reached the minimum protein recommendation. The occurrence of mortality was associated with nutritional diagnosis, body mass index (p = 0.023), arm circumference (p = 0.041) and protein adequacy (p = 0.012). Conclusion Nutritional status and protein intake were significantly associated with the clinical outcomes of critically ill patients.

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“…The safety at the beginning of nutritional support for hemodynamically unstable patients is still under debate. Hypoperfusion may originate in the gastrointestinal tissues, making it the primary target of therapeutic support actions 16 . Minimally preserved motility, absorptive capacity and barrier function are prerequisites for using the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

“…Minimally preserved motility, absorptive capacity and barrier function are prerequisites for using the gastrointestinal tract. The greatest advantages of the early onset of EN among hemodynamically unstable patients are favoring the distribution of splanchnic blood flow due to the presence of food, the functional preservation of the mucosal barrier, the modulation of the neuroendocrine response, reducing metabolic stress, supplying energy to cells and the attenuation of bacterial translocation 16 .…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Failure to Reach Total Energy Value in an Intensive Care Unit

Medeiros¹,

Pádua²,

Medeiros³

et al. 2018

SaudPesq

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The objective was identify the risk factors associated with the failure to total energy value. A prospective cohort study was conducted in an intensive care unit with 87 patients receiving exclusive enteral nutrition therapy. The Kaplan-Meier and Cox regression analysis were used to evaluate the results. Regarding the patients, 35.6% were aged between 31 and 50 years, and 58.6% were males. At the end of the third day, 70.8% reached the total recommended energy value. Postoperative patients (HR: 7.09; 95% CI: 2.02-24.81), hemodynamically unstable patients (HR: 5.97; 95% CI: 1.11-31.99) and those who were fasting for the performance of tests (HR: 4.95; 95% CI: 1.01-24.61) presented a greater risk of not reaching the recommended value. The number of patients who achieved the total energy value was adequate, but can be optimized by the evaluation of these identified factors.

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How could we make nutrition in the intensive care unit simple?

Cited by 8 publications

References 18 publications

Key Aspects in Nutritional Management of COVID-19 Patients

Key Aspects in Nutritional Management of COVID-19 Patients

Impact of protein intake and nutritional status on the clinical outcome of critically ill patients

Risk Factors for Failure to Reach Total Energy Value in an Intensive Care Unit

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