There is ongoing debate about the role of nutrition during critical illness in terms of long-term outcomes. Even taking into account the inability to adequately assess all biological mechanisms associated with nutrition, it should be recognized that the available randomized trials, nutritional support during the early phase of critical illness, when considered in isolation from other treatment, may have very limited long-term functional value. This review focuses on recent clinical studies and evaluating the impact of critical nutrition on long-term physical and functional recovery. Critical survival is becoming an increasingly important subject of attention. Future research on nutritional support should consider specific factors that can provide measurable benefits in terms of both physical and functional recovery. These factors include the development of strategies to ensure adequate nutritional interventions, the provision of nutrition for a period of time in which biologically it is possible to observe differences in the results assessed, and the selection of appropriate methods of assessing the results recorded at clinically significant time points. One of these results is an assessment of muscle mass and function, as well as quality of life. In addition, selection of patients who are most likely to benefit from nutritional interventions and nutritional research after transfer from ICU deserves special attention.

Цель. Изучение летальности и факторов риска смерти больных с COVID-19, госпитализированных для респираторной поддержки в отделения реанимации и интенсивной терапии (ОРИТ) лечебных учреждений Российской Федерации. Материал и методы. Ретроспективное исследование было выполнено в Федеральном дистанционном консультативном центре анестезиологии и реаниматологии для взрослых пациентов с COVID-19 на базе Первого МГМУ им. И.М. Сеченова. В исследование включали всех пациентов с известными исходами (смерть от любых причин или выздоровление) SARS-CoV-2 пневмонии, осложнившейся острым респираторным дистресс синдромом (ОРДС), которые были проконсультированы с 16 марта по 3 мая 2020 г. Факторы риска смерти анализировали с помощью многофакторной регрессионной модели Кокса. Результаты. В исследование были включены 1522 пациента, 864 (56,8%) мужчины и 658 (43,2%) женщин. Медиана возраста-62 года. 922 (60,6%) больных находились в ОРИТ стационаров Москвы и Московской области, 600 (39,4%)-лечебных учреждений в 70 регионах Российской Федерации. У 995 (65,4%) больных диагноз SARS-CoV-2 инфекции был подтвержден с помощью ПЦР. Умерли 995 (65,4%) пациентов, выжили 527 (34,6%). Основными причинами смерти были ОРДС (93,2%), сер

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Prophylaxis, diagnostics and correction of nutritional status disturbances is considered as one of the main treatment methods of patients with COVID-19 infection-directed to resolve systemic inflammatory response and correction of metabolic response to a viral infection. Systemic Inflammatory Reaction (SIR) manisfestation as a result of viral infection leads to pronounced metabolic processes disturbances. The main metabolic manifestations of SIR is reflected as hypermetabolic-hypercatabolic syndrome with complex disturbances of protein, lipids and carbohydrates metabolism, increased consumption of carbohydrate-lipid reserves and breakdown of tissue proteins. Thus, adequate correction of metabolic disorders and a wholesome nutritional support, taking into account the clinical picture, severity of the disease, ongoing respiratory and intensive care therapy is an integral component in treating patients with COVID-19 infection which determines the efficiency of its treatment and reduction in mortality. Given the relevance of the problem, the authors decided that it was important to increase the COVID-19 treatment efficacy by producing guidelines based on the most fundamental provisions of the modern approach to nutritional support in critical patients with community acquired pneumonia, acute respiratory failure, ARDS, sepsis, multiple organ failure.

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