Safety and tolerance of enteral nutrition in COVID-19 critically ill patients, a retrospective study. (June 2021)

• Record Type: Journal Article
• Authors: Osuna-Padilla, Iván; Rodríguez-Moguel, Nadia Carolina; Aguilar-Vargas, Adriana; Rodríguez-Llamazares, Sebastián
• Is Part Of: Clinical nutrition ESPEN. Volume 43(2021)
• Page Start: 495
• Page End: 500
• Publication Date: 2021-06
• Subjects: Enteral nutrition -- COVID-19 -- Gastrointestinal intolerance -- Critically ill patient -- Mechanical ventilation; Nutritionally induced diseases -- Periodicals; Metabolism -- Disorders -- Periodicals; 616.39005
• DOI: 10.1016/j.clnesp.2021.02.015
• Languages: English
• ISSNs: 2405-4577

Abstract

Summary: Background: There is a lack of evidence about the tolerance of enteral nutrition (EN) in COVID-19 critically ill patients. However, several gastrointestinal manifestations related to COVID-19 have been described. The aims of this study were to analyze the incidence of gastrointestinal intolerance (GI) associated to EN (diarrhea, vomiting, gastroparesis and constipation) and to describe energy/protein provision along with biochemical alterations during the first week of EN. Methods: A retrospective cohort of COVID-19 critically ill patients under mechanical ventilation. We reported daily enteral nutrition infusion and gastrointestinal manifestations within the first week of intubation and enteral nutrition initiation. Results: Fifty-two patients were included; 40.3% were overweight and 46.2% were obese. During the first 7 days of EN, manifestations of GI intolerance such as vomiting, diarrhea and gastroparesis were present in 18 patients (32.4%). Hypernatremia (39%) was the most frequent electrolyte abnormality. Only Acute Kidney Injury (AKI) diagnosis was associated with a higher energy deficit on day 7. No associations between drug prescription and GI intolerance were observed. On day 4, 94.5% of patients were receiving more than 80% of energy requirements and 94.2% of protein requirements. Accumulated energy and protein deficits at day 3 were 2171.2 ± 945 kcal and 114.9 ± 49.2 g, respectively; and 2586.4 ± 1151 kcal, 133.3 ± 60.4 g at day 7. Conclusion: Enteral nutrition is feasible and well-tolerated in COVID-19 patients with mechanical ventilation within the first week of enteral nutrition initiation. More studies are needed to elucidate the impact of nutritional therapy on infection course and outcomes.