Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position

Paula, Jéssica Alves de; Rabito, Estela Iraci; Justino, Sandra; Leite, Luíza Silva; Dantas, Danielle; Silva, Jéssica Sayume Makiyama da; Maffini, Larissa Farinha; Júnior, Odery Ramos

doi:10.1016/j.nutos.2022.08.003

Cited by 5 publications

(4 citation statements)

References 48 publications

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“…All the complications described in the study could have led to the need to reduce the doses of nutritional preparations or, ultimately, to completely switch to parenteral nutrition. Nutritional complications are a major problem in daily medical practice and may also result in poorer compliance in patients rotated for better ventilation, as in the case of COVID-19 patients [ 25 ]. Current guidelines recommend that enteral nutrition should be maintained during ventilation in a prone position [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Nutritional management in critically ill patients with COVID-19: a retrospective multicentre study

Danel,

Taborek,

Nowotarska

et al. 2024

ait

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In Poland, 108 000 patients were treated in intensive care units (ICUs) in 2021 [1]. At that time, the main medical challenge was the SARS-CoV-2 pandemic, and the largest group of patients comprised those with COVID-19. Treatment in the ICU requires the implementation of multidisciplinary approaches adjusted to the main cause of deterioration of health, as well as therapy targeting comorbidities [2]. A personalised approach is an important determinant of treatment effectiveness.

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Section: Discussionmentioning

confidence: 99%

Nutritional management in critically ill patients with COVID-19: a retrospective multicentre study

Danel,

Taborek,

Nowotarska

et al. 2024

ait

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“…Nuestros pacientes, presentaron buena tolerancia gástrica (85,4 %), superiores a los reportados por Alves de Paula et al en el subgrupo de pacientes con COVID-19 alimentados en decúbito prono (73,5%) (16) .…”

Section: Discussionunclassified

Nutrición enteral en pacientes críticos con COVID-19 ventilados en decúbito prono

Gavilán Rojas,

Fonclara López,

Fretes Apelt

et al. 2024

Rev. Nac. (Itauguá)

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Introducción: el SARS-CoV-2 desde el 2020 generó innumerables desafíos. El decúbito prono se utilizó para mejorar la oxigenación, y la terapia nutricional se adaptó para cubrir los requerimientos y reducir complicaciones. Objetivos: evaluar la tolerancia de la nutrición enteral y su adecuación energética en pacientes ventilados en decúbito prono con infección por SARS-CoV-2, en sala respiratoria del Departamento de Cuidados Intensivos Adultos del Hospital de Clínicas-Facultad de Ciencias Médicas - Universidad Nacional de Asunción, de marzo a julio 2021. Metodología: estudio observacional, descriptivo, retrospectivo, de corte transversal, de casos consecutivos, con información obtenida de fichas de pacientes de terapia intensiva, que recibieron soporte nutricional en posición prona. Se tomaron datos demográficos, clínicos y nutricionales. Se evaluó la tolerancia nutricional durante la posición prona, definiéndola como la presencia de un volumen de residuo gástrico < 500 mL cada 6 h.. La adecuación energética fue determinada teniendo en cuenta el porcentaje cumplido de la prescripción nutricional. Resultados: se reclutaron 41 pacientes. El 60,9 % eran hombres; la mediana de edad fue 55 años (RIC=23). Las principales comorbilidades fueron obesidad (57,3 %) e hipertensión arterial (43,9 %). El 85,4 % presentó buena tolerancia gástrica en posición prono, con residuo gástrico menor a 500 ml. El porcentaje de adecuación energética fue de 84 %. Conclusión: la terapia nutricional enteral en decúbito prono fue bien tolerada por la mayoría de nuestros pacientes, posibilitando alcanzar los requerimientos nutricionales indicados.

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“…Additional studies were recently reported on COVID-19 patients. In a retrospective study in patients with ARDS due to COVID-19, gastrointestinal intolerance was observed in 30.8% of 57 patients in the prone position and 23.2% of 69 patients in the supine position ( p = 0.81) [ 41 ]. In another multicenter retrospective study conducted in 83 critically ill patients with COVID-19, the prone position was not associated with a higher rate of high GRV (≥250 mL) [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Enteral Nutrition Safety and Outcomes of Patients with COVID-19 on Continuous Infusion of Neuromuscular Blockers: A Retrospective Study

Al-Dorzi,

Yaqoub,

Alalmaee

et al. 2023

Journal of Nutrition and Metabolism

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Background. Intravenous infusions of neuromuscular blocking agents (NMBAs) and prone positioning are recommended for acute respiratory distress syndrome (ARDS) due to COVID-19. The safety of enteral nutrition (EN) during these treatments is unclear. This study assessed EN tolerance and safety during NMBA infusion in proned and nonproned patients with ARDS due to COVID-19. Methods. This retrospective study evaluated patients who were admitted to a tertiary-care ICU between March and December 2020, had ARDS due to COVID-19, and received NMBA infusion. We assessed their EN data, gastrointestinal events, and clinical outcomes. The primary outcome was gastrointestinal intolerance, defined as a gastric residual volume (GRV) ≥500 ml or 200–500 ml with vomiting. We compared proned and nonproned patients. Results. We studied 181 patients (mean age 61.2 ± 13.7 years, males 71.1%, and median body mass index 31.4 kg/m2). Most (63.5%) patients were proned, and 94.3% received EN in the first 48 hours of NMBA infusion at a median dose <10 kcal/kg/day. GRV was mostly below 100 ml. Gastrointestinal intolerance occurred in 6.1% of patients during NMBA infusion and 10.5% after NMBA discontinuation (similar rates in proned and nonproned patients). Patients who had gastrointestinal intolerance during NMBA infusion had a higher hospital mortality (90.9% versus 60.0%; p = 0.05 ) and longer mechanical ventilation duration and ICU and hospital stays compared with those who did not. Conclusion. In COVID-19 patients on NMBA infusion for ARDS, EN was provided early at low doses for most patients, and gastrointestinal intolerance was uncommon in proned and nonproned patients, occurred at a higher rate after discontinuing NMBAs and was associated with worse outcomes. Our study suggests that EN was tolerated and safe in this patient population.

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Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position

Cited by 5 publications

References 48 publications

Nutritional management in critically ill patients with COVID-19: a retrospective multicentre study

Nutritional management in critically ill patients with COVID-19: a retrospective multicentre study

Nutrición enteral en pacientes críticos con COVID-19 ventilados en decúbito prono

Enteral Nutrition Safety and Outcomes of Patients with COVID-19 on Continuous Infusion of Neuromuscular Blockers: A Retrospective Study

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