Nutrition Support in the ICU—A Refresher in the Era of COVID-19

Micić, Dejan; Wall, Elizabeth; Semrad, Carol E.

doi:10.14309/ajg.0000000000000761

Cited by 4 publications

(14 citation statements)

References 12 publications

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“…According to Thibault et al [15] , the use of IC is indicated only in patients with a stay of >10 days in the ICU and in those using total parenteral nutrition, to avoid overfeeding. Furthermore, Micic et al [16] indicated the use of IC in case of prolonged intubation (>7 days) for patients admitted to the ICU. An interesting solution was proposed by Stachowska et al [17] , who supported IC as the first line and, in case of impossibility of use, suggested the calculation of caloric needs by expired volume translated into carbon dioxide release (VCO 2 ), which in turn can be obtained through MV, using a specific formula: resting energy expenditure (REE, kcal) = VCO 2 × 8.19.…”

Section: Nutrient Requirementsmentioning

confidence: 99%

“…A similar strategy was proposed by ESPEN, which recommends that critically intubated and MV patients receiving enteral nutrition should have their energy supply measured by oxygen consumption (VO 2 ), coming from the central pulmonary artery access, or from VCO 2 on the ventilator. [16] Both Micic et al [16] and ESPEN [13] recommend predictive formulas as the last option.…”

Section: Nutrient Requirementsmentioning

confidence: 99%

“…Thibault et al [15] stated that enteral or parenteral nutrition should be started at 10 kcal -1 kg -1 day -1 on the first day and increased by 5 calories/day over the course of 4 days, reaching the goal of 25 kcal -1 kg -1 day -1 . Micic et al [16] suggested a hypocaloric intake until the fifth day, increasing the intake on the following day. This strategy of starting with a low caloric dose was also reported by Wu et al [27] after evaluating critical patients.…”

Section: Nutrient Requirementsmentioning

confidence: 99%

See 2 more Smart Citations

Nutritional therapy for hospitalized patients with COVID-19: A narrative and integrative review

Grecco¹,

Araújo-Rossi²,

Nicoletti³

2022

Journal of Intensive Medicine

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Section: Nutrient Requirementsmentioning

confidence: 99%

Section: Nutrient Requirementsmentioning

confidence: 99%

Section: Nutrient Requirementsmentioning

confidence: 99%

See 1 more Smart Citation

Nutritional therapy for hospitalized patients with COVID-19: A narrative and integrative review

Grecco¹,

Araújo-Rossi²,

Nicoletti³

2022

Journal of Intensive Medicine

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“…All patients should receive prophylactic antibiotics as per guidelines. The “pull‐technique” should be used while minimizing suctioning in addition to practicing “cluster care” 4 while performing other procedures/imaging needed for the patient (PEG‐tube placement immediately before or after tracheostomy to minimize transport and exposure risk) (Table 2). In short, devising institutional guidelines regarding appropriate patient selection, optimizing the timing of PEG‐tube placement along with tracheostomy if needed, while observing a multidisciplinary team approach, and minimizing endoscopic personnel during the procedure can decrease the exposure risk and improve patient care as well as free‐up intensive care unit (ICU) resources.…”

Section: Advantages Disadvantagesmentioning

confidence: 99%

Percutaneous Endoscopic Gastrostomy tube placement in COVID‐19 patients: Multidisciplinary approach

Goyal

Perisetti

Tharian

2020

Digestive Endoscopy

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Percutaneous endoscopic gastrostomy (PEG-tube) placement is a relatively safe procedure for enteral nutrition in appropriately selected patients. Gastroenterologists are sought for PEG-tube placements in COVID-19 patients with vent-dependent respiratory failure. Although PEG-tube placement along with tracheostomy may expedite discharge planning, there are unique challenges for endoscopy staff because of the potential for viral transmission. 1 There is no gastroenterological society recommendation for a maximum duration of nasogastric (NG) or orogastric (OG) tube in critically ill patients. However, the general consensus is to wait about 4 weeks because of increased risk of complications beyond this duration. 2 If a PEG-tube is deemed necessary, a multidisciplinary discussion (patient's family, primary, procedural, and palliative care teams) should be held to discuss risks and benefits of the procedure, nutrition goals, and overall prognosis (Table 1). Guidelines from the COVID-19 tracheostomy task force recommend waiting for at least 21 days before performing a tracheostomy. 3 A similar window period of 3-4 weeks for PEG-tube placement can be considered to avoid transmission. Patients' transport should be minimized to reduce the transmission risk; however, barrier methods (plastic patient-isolation drapes) should be used if deemed necessary. A small size hole (about 6 inches) can be made in the drape to access expected site of PEG-tube placement. All patients should receive prophylactic antibiotics as per guidelines. The "pull-technique" should be used while minimizing suctioning in addition to practicing "cluster care" 4 while performing other procedures/imaging needed for the patient (PEG-tube placement immediately before or after tracheostomy to minimize transport and exposure risk) (Table 2). In short, devising institutional guidelines regarding appropriate patient selection, optimizing the timing of PEG-tube placement along with tracheostomy if needed, while observing a multidisciplinary team approach, and minimizing endoscopic personnel during the procedure can decrease the exposure risk and improve patient care as well as free-up intensive care unit (ICU) resources. Authors declare no conflicts of interest for this article.

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“…Trata-se de uma doença ocasionada por infecção viral pelo SARS-CoV-2 de rápida disseminação, resultando em doença crítica prolongada ou morte em diversos pacientes. Com o número crescente de casos e mortes relatado diariamente, a COVID-19 tornou-se uma das mais importantes crises de saúde pública na história moderna (Micic et al, 2020).…”

Section: Introductionunclassified

Parâmetros nutricionais de indivíduos com COVID-19 hospitalizados em UTI

Rêgo¹,

Moura

2021

RSD

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Por se tratar de uma doença que afeta principalmente o sistema respiratório, a COVID-19 pode evoluir para uma situação mais crítica, levando até mesmo à falência de múltiplos órgãos, chegando a ser fatal. Quadros nos quais complicações respiratórias agudas passam a requerer permanência prolongada em Unidades de Terapia Intensiva (UTIs) são as principais causas de morbidade e mortalidade em pacientes com COVID-19. A permanência em UTI, sobretudo em tempo prolongado, é, por si só, uma causa da alteração de parâmetros nutricionais. Diante disto, o presente trabalho tem como objetivo analisar o comportamento do estado e parâmetros nutricionais de pacientes com COVID-19 admitidos em UTI durante o curso da pandemia. Foi realizada uma revisão integrativa da literatura, na qual foi utilizado método sistematizado para síntese e análise dos trabalhos científicos disponíveis. Verificou-se que, nos casos de pacientes COVID-19 agravados, em tratamento em UTI, constatou-se significativa presença de comorbidades como diabetes, hipertensão e associação destas entre os indivíduos hospitalizados, bem como mudanças no perfil de ingestão calórica e proteica e no balanço nitrogenado. Também foi constatado que desnutrição e moderado a alto risco nutricional foram considerados fatores de risco para maiores períodos de internação hospitalar. A possibilidade de investigação de parâmetros mais minuciosos é travessada pelo próprio contexto pandêmico, no qual a urgência no manejo dos pacientes e a necessidade de isolamento e adoção de protocolos sanitários muitas vezes impossibilita a realização das pesquisas científicas com pacientes críticos em decorrência da COVID-19.

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Nutrition Support in the ICU—A Refresher in the Era of COVID-19

Cited by 4 publications

References 12 publications

Nutritional therapy for hospitalized patients with COVID-19: A narrative and integrative review

Nutritional therapy for hospitalized patients with COVID-19: A narrative and integrative review

Percutaneous Endoscopic Gastrostomy tube placement in COVID‐19 patients: Multidisciplinary approach

Parâmetros nutricionais de indivíduos com COVID-19 hospitalizados em UTI

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