Nutrition management for critically and acutely unwell hospitalised patients with coronavirus disease 2019 (COVID-19) in Australia and New Zealand

Chapple, Lee‐anne S.; Fetterplace, Kate; Asrani, Varsha M.; Burrell, Aidan; Cheng, Allen; Collins, Peter; Doola, Ra’eesa; Ferrie, Suzie; Marshall, Andrea P.; Ridley, Emma J.

doi:10.1016/j.aucc.2020.06.002

Cited by 51 publications

(115 citation statements)

References 16 publications

(3 reference statements)

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“…A recent prospective, randomized, unblinded, multicenter trial demonstrated that providing early nutritional support, mostly orally, in hospitalized patients at risk of malnutrition significantly decreased 30-day complications and mortality in comparison to patients on standard hospital diet [ 23 ]. The high probability of malnutrition [ 3 – 7 ] and its association with a worse clinical outcome [ 24 ] are justifying an active strategy of nutrition screening and support in the Covid-19 patient ( https://www.nutritioncare.org/uploadedFiles/Documents/Guidelines_and_Clinical_Resources/Nutrition%20Therapy%20COVID-19_SCCM-ASPEN.pdf ) [ 4 , 5 , 25 ]. This would help the patients reinforcing their immune defenses and potentially limiting the evolution toward a severe form of the disease.…”

Section: Rationale For Nutrition Support In the Covid-19 Patientmentioning

confidence: 99%

“…As recommended ( https://www.nutritioncare.org/uploadedFiles/Documents/Guidelines_and_Clinical_Resources/Nutrition%20Therapy%20COVID-19_SCCM-ASPEN.pdf ) [ 4 , 5 , 12 , 25 , 52 ], EN through a NGT should be preferred as a first line nutrition support because of its expected benefits in the Covid-19 patient (see 1st part). However, Covid-19 patients are mostly managed by medical and nonmedical staff often not familiar with nutrition support techniques.…”

Section: Challenge 6: Adaptation Of Hospital Food Delivery Needs To Bmentioning

confidence: 99%

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How the Covid-19 epidemic is challenging our practice in clinical nutrition—feedback from the field

et al. 2020

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The viral epidemic caused by the new Coronavirus SARS-CoV-2 is responsible for the new Coronavirus disease-2019 (Covid-19). Fifteen percent of the Covid-19 patients will require hospital stay, and 10% of them will need urgent respiratory and hemodynamic support in the intensive care unit (ICU). Covid-19 is an infectious disease characterized by inflammatory syndrome, itself leading to reduced food intake and increased muscle catabolism. Therefore Covid-19 patients are at high risk of being malnourished, making the prevention of malnutrition and the nutritional management key aspects of care. Urgent, brutal and massive arrivals of patients needing urgent respiratory care and artificial ventilation lead to the necessity to reorganize hospital care, wards and staff. In that context, nutritional screening and care may not be considered a priority. Moreover, at the start of the epidemic, due to mask and other protecting material shortage, the risk of healthcare givers contamination have led to not using enteral nutrition, although indicated, because nasogastric tube insertion is an aerosolgenerating procedure. Clinical nutrition practice based on the international guidelines should therefore adapt and the use of degraded procedures could unfortunately be the only way. Based on the experience from the first weeks of the epidemic in France, we emphasize ten challenges for clinical nutrition practice. The objective is to bring objective answers to the most frequently met issues to help the clinical nutrition caregivers to promote nutritional care in the hospitalized Covid-19 patient. We propose a flow chart for optimizing the nutrition management of the Covid-19 patients in the non-ICU wards.

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Section: Rationale For Nutrition Support In the Covid-19 Patientmentioning

confidence: 99%

Section: Challenge 6: Adaptation Of Hospital Food Delivery Needs To Bmentioning

confidence: 99%

How the Covid-19 epidemic is challenging our practice in clinical nutrition—feedback from the field

et al. 2020

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“…22 Under the best of the circumstances, the adoption of indirect calorimetry has been challenging, making it practically impossible to apply this technology in the middle of a pandemic. 27 Indirect calorimetry requires training, a stable patient with specific ventilation parameters such as a low inspired fraction of oxygen, and a significant amount of time at the bedside. In addition, the data obtained are difficult to interpret in patients that have significant ventila-tion perfusion (V/Q) mismatch, as is seen frequently during COVID-19, with the potential to generate falsely elevated values.…”

Section: Nutrition Assessmentmentioning

confidence: 99%

Lessons Learned in Nutrition Therapy in Patients With Severe COVID‐19

Ochoa

Cárdenas

Goiburu

et al. 2020

J Parenter Enteral Nutr

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The coronavirus disease 2019 (COVID-19) pandemic has reached worldwide, and until a vaccine is found, it will continue to cause significant morbidity and mortality. The clinical presentation of COVID-19 ranges from that of being asymptomatic to developing a fatal illness characterized by multiple organ involvement. Approximately 20% of the patients will require hospitalization; onequarter of hospitalized patients will develop severe COVID-19 requiring admission to the intensive care unit, most frequently, with acute respiratory failure. An ongoing effort is being made to identify the patients that will develop severe COVID-19. Overall, patients present with 3 different phenotypes of nutrition risk: (1) the frail older patient, (2) the patient with severe ongoing chronic illness, and (3) the patient with severe and morbid obesity. These 3 phenotypes represent different nutrition risks and diverse nutrition interventions. This article explores the different potential approaches to nutrition intervention in patients with COVID-19, evaluating, in this process, the challenges faced in the implementation of guidelines written by different societies.

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“…Leadership is demonstrable in much of the research in recent editions of Nutrition & Dietetics. This includes Chapple and colleagues' guidelines for managing critically and acutely unwell adult patients hospitalised with COVID‐19 14 and Langston's study showing the vital role of dietitian leadership in multidisciplinary lifestyle interventions 15 . Indeed, Porter et al show tremendous leadership, putting aside individual interests and recognising that to maximise research efforts within our profession requires a focus on key priorities to funnel limited resources such that greater impacts can be realised, identifying five key themes for dietetics research 16 .…”

mentioning

confidence: 99%

Leadership and practice in times of complexity and uncertainty

Palermo

2020

Nutrition & Dietetics

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Nutrition management for critically and acutely unwell hospitalised patients with coronavirus disease 2019 (COVID-19) in Australia and New Zealand

Cited by 51 publications

References 16 publications

How the Covid-19 epidemic is challenging our practice in clinical nutrition—feedback from the field

How the Covid-19 epidemic is challenging our practice in clinical nutrition—feedback from the field

Lessons Learned in Nutrition Therapy in Patients With Severe COVID‐19

Leadership and practice in times of complexity and uncertainty

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