Better nutritional adequacy is associated with lower mortality in critically ill patients with covid-19

Abstract

Rationale: The distal end of the feeding tube (FT) has an important role for drugs in terms of bioavailability, complications and interactions. This study was aimed to determine the drugs that are not appropriate for post-pyloric administration in patients followed by nutrition support team. Methods: This study was retrospectively conducted in clinical nutrition unit of a university hospital. Patients records between January 2017-December 2020 was evaluated. Adult patients (▫18 years) with post-pyloric FT were included. The appropriateness of drugs that administered was assessed by using the information provided by the manufacturer, scientific databases and literature. The study was approved by the local Ethics Committee. Results: Total of 2247 patients were evaluated during the study period and 65 (2.89%) of those were included; 36 (55.4%) of them were male, median age was 62 (range:22-91) and median follow up period was 15 days (range:7-30 days). Ten patients (15.4%) had FT related mechanical complications. While patients' 463 (28.52%) out of 1623 drugs administered via FT were evaluated, appropriate administration, administration without specific information and inappropriate administration were detected in 212 (45.78%), 211 (45.57%) and 40 (8.63%) drugs, respectively. Common inappropriate drugs were sucralfate (25%), folic acid (7.5%) and mycophenolate mofetil (5%). Drugs such as levofloxacin, rifampicin, levothyroxine, ciprofloxacin, warfarin were appropriate for administration through post-pyloric feeding, however nutrient-drug interactions were determined with them. Conclusion: Almost half of the drugs were appropriate for post-pyloric administration. Considering the risks such as ineffectiveness or toxicity of the drugs, to provide optimal pharmaceutical and nutritional treatment together, drugs should be evaluated carefully before administration via post-pyloric FT.