Evaluation of implementation of fasting guidelines for enterally fed critical care patients

“…The proper delivery of nutrients to critical COVID-19 patients may be achieved via prompt initiation of volumecontrolled, higher-protein enteral formula and monitoring gastric residual volume [63]. Adherence to fasting guidelines is necessary to ensure adequate enteral nutrition delivery and to reduce the duration of feed breaks [85]. Indirect calorimetry should be avoided because it puts healthcare professionals at risk for infection secondary to aerosol exposure [63].…”

Section: Current Knowledge On the Management Of Malnutrition In Covid-19mentioning

confidence: 99%

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

Ali

Kunugi

2021

IJERPH

View full text Add to dashboard Cite

Malnutrition is common among severe patients with coronavirus disease 2019 (COVID-19), mainly elderly adults and patients with comorbidities. It is also associated with atypical presentation of the disease. Despite the possible contribution of malnutrition to the acquisition and severity of COVID-19, it is not clear which nutritional screening measures may best diagnose malnutrition in these patients at early stages. This is of crucial importance given the urgency and rapid progression of the disease in vulnerable groups. Accordingly, this review examines the available literature for different nutritional screening approaches implemented among COVID-19 patients, with a special focus on elderly adults. After a literature search, we selected and scrutinized 14 studies assessing malnutrition among COVID-19 patients. The Nutrition Risk Screening 2002 (NRS-2002) has demonstrated superior sensitivity to other traditional screening measures. The controlling nutritional status (CONUT) score, which comprises serum albumin level, cholesterol level, and lymphocytes count, as well as a combined CONUT-lactate dehydrogenase-C-reactive protein score expressed a predictive capacity even superior to that of NRS-2002 (0.81% and 0.92% vs. 0.79%) in midlife and elder COVID-19 patients. Therefore, simple measures based on routinely conducted laboratory investigations such as the CONUT score may be timely, cheap, and valuable alternatives for identifying COVID-19 patients with high nutritional risk. Mini Nutritional Assessment (MNA) was the only measure used to detect residual malnutrition and high malnutrition risk in remitting patients—MNA scores correlated with hypoalbuminemia, hypercytokinemia, and weight loss. Older males with severe inflammation, gastrointestinal symptoms, and pre-existing comorbidities (diabetes, obesity, or hypertension) are more prone to malnutrition and subsequently poor COVID-19 prognosis both during the acute phase and during convalescence. Thus, they are in need of frequent nutritional monitoring and support while detecting and treating malnutrition in the general public might be necessary to increase resilience against COVID-19.

show abstract

“…The reasons for this poor delivery and resulting energy and protein deficits are the frequent interruptions to enteral feeding for procedures and gastrointestinal intolerance (17,18) . When an energy and protein deficit accumulates, critically ill patients start experiencing ICU related complications (18) and poor recovery (19) Measures are needed such as ICU fasting guidelines to tackle unnecessary delays and interruptions to nutrition delivery (20,21) .…”

Section: Discussionmentioning

confidence: 99%