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Chapela SP, Manzanares W, Quesada E, Reberendo MJ, Baccaro F, Aversa I, Kecskes CE, Magnifico L, Gonzalez V, Bolzicco D, Baraglia N, Navarrete P, Manrique E, Cascaron MF, Dietrich A, Asparch J, Peralta LB, Galletti C, Capria ML, Lombi Y, Rodriguez MC, Luna CE, Martinuzzi ALN. Nutrition intake in critically ill patients with coronavirus disease (COVID-19): A nationwide, multicentre, observational study in Argentina. ENDOCRINOL DIAB NUTR 2023; 70:245-254. [PMID: 37116970 PMCID: PMC10131094 DOI: 10.1016/j.endien.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/09/2022] [Indexed: 04/30/2023]
Abstract
INTRODUCTION In 2020 the pandemic caused by SARS-COV-2 demanded an enormous number of healthcare resources in order to guarantee adequate treatment and support for those patients. This study aims to assess caloric and protein intake and evaluate its associations with relevant clinical outcomes in critically ill with coronavirus disease (COVID-19) patients. METHODS A nationwide, multicentre prospective observational study including twelve Argentinian intensive care units (ICUs,) was conducted between March and October 2020. INCLUSION CRITERIA Adult ICU patients>18 years admitted to the ICU with COVID-19 diagnosis and mechanical ventilation for at least 48h. Statistical analysis was carried out using IBM-SPSS© 24 programme. RESULTS One hundred and eighty-five patients were included in the study. Those who died had lower protein intake (0.73g/kg/day (95% confidence interval (CI) 0.70-0.75 vs 0.97g/kg/day (CI 0.95-0.99), P<0.001), and lower caloric intake than those who survived (12.94kcal/kg/day (CI 12.48-13.39) vs 16.47kcal/kg/day (CI 16.09-16.8), P<0.001). A model was built, and logistic regression showed that factors associated with the probability of achieving caloric and protein intake, were the early start of nutritional support, modified NUTRIC score higher than five points, and undernutrition (Subjective Global Assessment B or C). The patients that underwent mechanical ventilation in a prone position present less caloric and protein intake, similar to those with APACHE II>18. CONCLUSIONS Critically ill patients with COVID-19 associated respiratory failure requiring mechanical ventilation who died in ICU had less caloric and protein intake than those who survived. Early start on nutritional support and undernutrition increased the opportunity to achieve protein and caloric goals, whereas the severity of disease and mechanical ventilation in the prone position decreased the chance to reach caloric and protein targets.
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Affiliation(s)
- Sebastián Pablo Chapela
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina; Universidad de Buenos Aires, Facultad de Medicina, Departamento de Bioquímica, Buenos Aires, Argentina
| | - William Manzanares
- Chair of intensive Medicina, Faculty of Medicine, Universidad de la Republica, Montevideo, Uruguay
| | - Eliana Quesada
- Chapter of Dieticians in ICU (CALINU), of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - María Jimena Reberendo
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Fernando Baccaro
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Irina Aversa
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Claudia Elisabeth Kecskes
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Lorena Magnifico
- Chapter of Dieticians in ICU (CALINU), of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Victoria Gonzalez
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina; Universidad Católica de Córdoba, Master's in Obesology, Córdoba, Argentina; Universidad Nacional de Córdoba, Faculty of Chemical Sciences, Master's in Food Science and Technology, Córdoba, Argentina
| | - Daniela Bolzicco
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Nancy Baraglia
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Priscila Navarrete
- Chapter of Dieticians in ICU (CALINU), of the Argentinian Society of Intensive Care Medicine (SATI), Argentina; Universidad Juan Agustín Masa, Professional Practice, Mendoza, Argentina
| | - Ezequiel Manrique
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - María Fernanda Cascaron
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Ailen Dietrich
- Chapter of Dieticians in ICU (CALINU), of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Jesica Asparch
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Leticia Betiana Peralta
- Chapter of Dieticians in ICU (CALINU), of the Argentinian Society of Intensive Care Medicine (SATI), Argentina; Universidad Austral, Faculty of Biomedical Sciences, Food and Nutrition Assessment of Adults, Buenos Aires, Argentina
| | - Cayetano Galletti
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - María Laura Capria
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Yamila Lombi
- Committee of Nutrition Support and Metabolism (COSONUME) of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Marian Cecilia Rodriguez
- Chapter of Dieticians in ICU (CALINU), of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
| | - Camila Ester Luna
- Chapter of Dieticians in ICU (CALINU), of the Argentinian Society of Intensive Care Medicine (SATI), Argentina
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