Nutrition Support in Adult Patients Receiving Extracorporeal Membrane Oxygenation

Bear, Danielle E.; Smith, Elizabeth Viner; Barrett, Nicholas

doi:10.1002/ncp.10211

Cited by 46 publications

(46 citation statements)

References 41 publications

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“…Early observational data from Ridley et al found bowel ischemia in 4.5% of 107 patients on ECMO receiving EN 33 . Other observational data show safety and tolerability of gastric EN delivery during ECMO 34 . Extrapolating from observational data from the H1N1 pandemic, most patients tolerated early EN within 24 hours of initiating ECMO.…”

Section: Recommendation 8: Nutrition Therapy During Ecmomentioning

confidence: 94%

Nutrition Therapy in Critically Ill Patients With Coronavirus Disease 2019

Martindale

Patel

Taylor

et al. 2020

J Parenter Enteral Nutr

193

298

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In the midst of a coronavirus disease 2019 (COVID‐19) pandemic, a paucity of data precludes derivation of COVID‐19–specific recommendations for nutrition therapy. Until more data are available, focus must be centered on principles of critical care nutrition modified for the constraints of this disease process, ie, COVID‐19–relevant recommendations. Delivery of nutrition therapy must include strategies to reduce exposure and spread of disease by providing clustered care, adequate protection of healthcare providers, and preservation of personal protective equipment. Enteral nutrition (EN) should be initiated early after admission to the intensive care unit (ICU) using a standard isosmolar polymeric formula, starting at trophic doses and advancing as tolerated, while monitoring for gastrointestinal intolerance, hemodynamic instability, and metabolic derangements. Intragastric EN may be provided safely, even with use of prone‐positioning and extracorporeal membrane oxygenation. Clinicians should have a lower threshold for switching to parenteral nutrition in cases of intolerance, high risk of aspiration, or escalating vasopressor support. Although data extrapolated from experience in acute respiratory distress syndrome warrants use of fiber additives and probiotic organisms, the lack of benefit precludes a recommendation for micronutrient supplementation. Practices that increase exposure or contamination of equipment, such as monitoring gastric residual volumes, indirect calorimetry to calculate requirements, endoscopy or fluoroscopy to achieve enteral access, or transport out of the ICU for additional imaging, should be avoided. At all times, strategies for nutrition therapy need to be assessed on a risk/benefit basis, paying attention to risk for both the patient and the healthcare provider.

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Section: Recommendation 8: Nutrition Therapy During Ecmomentioning

confidence: 94%

Nutrition Therapy in Critically Ill Patients With Coronavirus Disease 2019

Martindale

Patel

Taylor

et al. 2020

J Parenter Enteral Nutr

193

298

View full text Add to dashboard Cite

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“…Data from several observational trials and a review article support the safety and tolerability of EN delivery during ECMO. 22 Large database studies on prospectively collected data of several thousand patients report that early EN resulted in decreased mortality, with no significant increase in episodes of ischemic bowel. 23,24 Thus, early EN may be initiated during use of ECMO, starting at trophic doses, with slow advancement over the first week of critical illness in patients with COVID-19.…”

Section: Nutrition Therapy During Ecmomentioning

confidence: 99%

Relevant Nutrition Therapy in COVID‐19 and the Constraints on Its Delivery by a Unique Disease Process

2020

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Worldwide, as of July 2020, >13.2 million people have been infected by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) virus. The spectrum of coronavirus disease 2019 (COVID‐19) ranges from mild illness to critical illness in 5% of cases. The population infected with SARS‐CoV‐2 requiring an intensive care unit admission often requires nutrition therapy as part of supportive care. Although the various societal guidelines for critical care nutrition meet most needs for the patient with COVID‐19, numerous factors, which impact the application of those guideline recommendations, need to be considered. Since the SARS‐CoV‐2 virus is highly contagious, several key principles should be considered when caring for all patients with COVID‐19 to ensure the safety of all healthcare personnel involved. Management strategies should cluster care, making all attempts to bundle patient care to limit exposure. Healthcare providers should be protected, and the spread of SARS‐CoV‐2 should be limited by minimizing procedures and other interventions that lead to aerosolization, avoiding droplet exposure through hand hygiene and use of personal protective equipment (PPE). PPE should be preserved by decreasing the number of individuals providing direct patient care and by limiting the number of patient interactions. Enteral nutrition (EN) is tolerated by the majority of patients with COVID‐19, but a relatively low threshold for conversion to parenteral nutrition should be maintained if increased exposure to the virus is required to continue EN. This article offers relevant and practical recommendations on how to optimize nutrition therapy in critically ill patients with COVID‐19.

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“…Дані одного з досліджень свідчать про виявлення ішемії кишечника у 4,5% із 107 пацієнтів під час ЕКМО, які отримували ЕХ [33]. Інші дані літератури спостережень показують безпеку та переносимість проведення шлункового ЕХ під час ЕКМО [34].…”

Section: комбіноване (ентеральне плюс парентеральне харчування)unclassified

Nutritive Therapy of Patients With Covid-19. Review of Recommendations

Дубров¹,

Славута²,

Гавриленко³

et al. 2020

Pain Anaesth Int Care

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Пандемія коронавірусної хвороби, що супроводжується широким розповсюдженням захворювання, високим рівнем летальності, безпрецедентним навантаженням на системи охорони здоров'я, спонукає науковців та лікарів до пошуку ефективних заходів лікування та профілактики COVID-19. В умовах відсутності етіологічного лікування, основним методом терапії є симптоматичний підхід. Одним з необхідних компонентів лікування пацієнтів з COVID-19, які перебувають у ВІТ, є адекватна нутритивна терапія. Загальні принципи клінічного харчування загалом такі ж, як і для основної популяції пацієнтів ВІТ з поліморбідністю, з особливим акцентом на безпеку медичного персоналу. В статті наводиться огляд літературних даних з питань нутритивної підтримки пацієнтів з COVID-19, які потребують інтенсивної терапії.

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Nutrition Support in Adult Patients Receiving Extracorporeal Membrane Oxygenation

Cited by 46 publications

References 41 publications

Nutrition Therapy in Critically Ill Patients With Coronavirus Disease 2019

Nutrition Therapy in Critically Ill Patients With Coronavirus Disease 2019

Relevant Nutrition Therapy in COVID‐19 and the Constraints on Its Delivery by a Unique Disease Process

Nutritive Therapy of Patients With Covid-19. Review of Recommendations

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