Nutritional Status Deterioration Occurs Frequently During Children’s ICU Stay*

Valla, Frédéric V.; Baudin, Florent; Roux, Bénédicte Gaillard Le; Ford-Chessel, Carole; Gervet, Elodie; Giraud, C; Ginhoux, Tiphanie; Cour-Andlauer, Fleur; Javouhey, Étienne; Tume, Lyvonne N.

doi:10.1097/pcc.0000000000001979

Cited by 38 publications

(41 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This could be even truer in severe COVID-19 patients hospitalized in intensive care unit (ICU), which represents approximately 5% of patients with SARS-CoV-2 infection [4]. Indeed, weight loss and acute skeletal muscle wasting following ICU is common [5,6] and the prominent inflammatory profile of severe COVID-19 [7,8] and long length of stay in ICU [9] could lead to especially high rates of malnutrition. Nevertheless, there are almost no data on the risk of malnutrition in critically ill COVID-19 patients and their short-and long-term nutritional status after ICU discharge remains to be specified.…”

Section: Introductionmentioning

confidence: 99%

Evolution of the nutritional status of COVID-19 critically-ill patients: A prospective observational study from ICU admission to three months after ICU discharge

et al. 2022

View full text Add to dashboard Cite

Background and aims Malnutrition following intensive care unit (ICU) stay is frequent and could be especially prominent in critically ill Coronavirus Disease 2019 (COVID-19) patients as they present prolonged inflammatory state and long length stay. We aimed to determine the prevalence of malnutrition in critically ill COVID-19 patients both at the acute and recovery phases of infection. Methods We conducted a prospective observational study including critically ill COVID-19 patients requiring invasive mechanical ventilation discharged alive from a medical ICU of a university hospital. We collected demographic, anthropometric and ICU stay data (SAPS2, recourse to organ support and daily energy intake). Nutritional status and nutritional support were collected at one month after ICU discharge (M1) by phone interview and at 3 months after ICU discharge (M3) during a specialized and dedicated consultation conducted by a dietitian. Malnutrition diagnosis was based on weight loss and body mass index (BMI) criteria following the Global Leadership Initiative on Malnutrition. Primary outcome was the prevalence of malnutrition at M3 and secondary outcomes were the evolution of nutritional status from ICU admission to M3 and factors associated with malnutrition at M3. Results From march 13 th to may 15 th , 2020, 38 patients were discharged alive from the ICU, median [IQR] age 66 [59-72] years, BMI 27.8 [25.5-30.7] kg/m 2 and SAPS2 47 [35-55]. Thirty-three (86%) patients were followed up to M3. Prevalence of malnutrition increased during the ICU stay, from 18% at ICU admission to 79% at ICU discharge and then decreased to 71% at M1 and 53% at M3. Severe malnutrition prevailed at ICU discharge with a prevalence of 55% decreasing 32% at M3. At M3, the only factors associated with malnutrition in univariate analysis were the length of invasive mechanical ventilation and length of ICU stay (25 [16-39] vs. 11 [9-12] days, P=0.006 and 28 [21-42] vs. 15 [11-17] days, P=0.010, respectively), while no ICU preadmission and admission factors, nor energy and protein intakes distinguished the two groups. Only 32% of undernourished patients at M3 had benefited from a nutritional support. Conclusion Malnutrition is frequent, protracted and probably underrecognized among critically ill Covid-19 patients requiring invasive mechanical ventilation with more than half patients still being undernourished three months after ICU discharge. A particular attention should be paid to the nutritional status of these patients not only during their ICU stay but also following ICU discharge.

show abstract

Section: Introductionmentioning

confidence: 99%

Evolution of the nutritional status of COVID-19 critically-ill patients: A prospective observational study from ICU admission to three months after ICU discharge

et al. 2022

View full text Add to dashboard Cite

show abstract

“…showed that the median LOS among survivors of critically ill COVID-19 patients was 17 d (interquartile range, [16][17][18][19][20][21][22][23], and the median length of intensive care unit (ICU) stay among survivors was 14 d (interquartile range, 4-17). Prolonged length of hospital stay may be accompanied by loss in weight and muscle mass (72) , leading to cachexia (73,74) .…”

Section: Cachexia and Its Relation To Covid-19mentioning

confidence: 99%

“…Changes in nutritional status and weight loss during hospitalisation are largely reported in some populations (17,18) , but still not explored in COVID-19 patients (19) . In fact, few studies reported nutritional status of patients during hospitalisation for COVID-19 (20) .…”

mentioning

confidence: 99%

Can COVID-19 be a risk for cachexia for patients during intensive care? Narrative review and nutritional recommendations

et al. 2020

View full text Add to dashboard Cite

Although increased weight, and particularly obesity, has been associated with a more severe clinical course of COVID-19 and risk of fatality, the course of the illness can lead to prolonged length of stay. Changes in nutritional status and weight loss during hospitalization are largely reported in some populations, but still not explored in COVID-19 patients. Considering that patients with COVID-19 show an increased inflammatory response, other signs and symptoms, which can lead to weight and muscle loss should be monitored. The aim of this article was to establish possible connections between COVID-19, prolonged hospitalization and muscle wasting, as well as to propose nutritional recommendations for the prevention and treatment of cachexia, through a narrative review. Identification of risk and presence of malnutrition should be an early step in general assessment of all patients, with regard to more at-risk categories including older adults and individuals suffering from chronic and acute disease conditions, as COVID-19. The deterioration of nutritional status, and consequently cachexia, increase the risk of mortality, and need to be treated with attention as other complications. There is, however, little hard evidence of nutritional approaches in assisting COVID-19 treatment or its management including cachexia.

show abstract

“…Critically ill children often experience significant weight loss during their paediatric intensive care (PICU) stay, which is associated with impaired outcomes. 1,2 Recent guidelines recommend monitoring faltering growth occurrence and attempting to prevent it through a proactive nutritional support strategy. 3 Enteral nutrition is recommended and is mainly provided through a gastric/enteral tube until the child is awake and capable of eating/feeding orally.…”

Section: Introductionmentioning

confidence: 99%

Improving mealtimes for paediatric intensive care children and families: A quality improvement initiative

Monte

Petit

Baudin

et al. 2020

Nursing in Critical Care

Self Cite

View full text Add to dashboard Cite

Background: Many critically ill children can be fed orally at some point during their paediatric intensive care (PICU) stay, but reduced appetite and other factors may impact their intake. At home, oral feeding is usually delivered by parents, so involving parents more actively during mealtimes in the PICU may contribute to improved patient/family satisfaction.Aim: To assess the impact of a new "room service" initiative involving parents on mealtime quality and on both family and health care professional (HCP) satisfaction.Methods: A prospective, single-centre, before-and-after intervention study was designed as part of a PICU quality-of-care improvement programme in 2013 to 2016. Two questionnaires assessing oral nutrition practices and family/HCP overall satisfaction were disseminated among the parents of critically ill children capable of oral feeding during their PICU admission and among the whole PICU HCP team (nurses, nurse assistants, and medical doctors). Categorical variables were compared using the chi-square test, and Likert scales were compared between groups with the Mann-Whitney-Wilcoxon test.Results: the pre-intervention surveys were completed by 97 of 130 (75%) HCPs and 52 families and the post-intervention surveys by 74 of 130 (57%) HCPs and 54 families. After the intervention, a marked improvement was observed in the overall quality of meal service rating by both HCPs and families (medians and IQR: 5 (5-7) to 7 (7, 8) and 6 (6-8) to 8 (7-9), respectively; P < .01) and also in parents' involvement; in children's, families', and HCP satisfaction; in meal-dedicated facilities and equipment; and in perception that oral nutrition is an important aspect of PICU care.Conclusions: Implementation of an improved "room service" initiative in the PICU was feasible and improved the perceived quality of care and satisfaction around oral feeding. This family-centred care initiative can be integrated in an overall quality improvement strategy.

show abstract

Nutritional Status Deterioration Occurs Frequently During Children’s ICU Stay*

Cited by 38 publications

References 25 publications

Evolution of the nutritional status of COVID-19 critically-ill patients: A prospective observational study from ICU admission to three months after ICU discharge

Evolution of the nutritional status of COVID-19 critically-ill patients: A prospective observational study from ICU admission to three months after ICU discharge

Can COVID-19 be a risk for cachexia for patients during intensive care? Narrative review and nutritional recommendations

Improving mealtimes for paediatric intensive care children and families: A quality improvement initiative

Contact Info

Product

Resources

About