Van de Wyngaert Caroline, Dewulf Joseph P, Collienne Christine, Laterre Pierre-François, Hantson Philippe
Department of Intensive Care, Cliniques St-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
Department of Clinical Chemistry, Cliniques St-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
Case Rep Crit Care. 2022 Aug 17;2022:4142539. doi: 10.1155/2022/4142539. eCollection 2022.
A 60-year-old man was admitted in the intensive care unit (ICU) for a rapidly progressive respiratory failure due to SARS-CoV-2 infection. He developed numerous complications including acute kidney injury (AKI) requiring prolonged continuous renal replacement therapy (CRRT). Enteral feeding was initiated on day 8. Despite nutritional management, there was a remarkable amyotrophy and weight loss. On day 85 in the ICU, the patient became progressively unresponsive. An extensive metabolic workup was performed, and blood results showed hyperammoniemia and hypertriglyceridemia. Plasma free carnitine level was low, as was also copper. After carnitine supplementation, the neurological condition rapidly improved, and metabolic perturbations regressed. Prolonged CRRT may be complicated by clinically significant deficiency in micronutrients and trace elements.
一名60岁男性因感染新型冠状病毒肺炎导致快速进展性呼吸衰竭入住重症监护病房（ICU）。他出现了许多并发症，包括急性肾损伤（AKI），需要长时间持续肾脏替代治疗（CRRT）。在第8天开始肠内喂养。尽管进行了营养管理，但仍出现了明显的肌萎缩和体重减轻。在ICU的第85天，患者逐渐失去反应。进行了全面的代谢检查，血液检查结果显示高氨血症和高甘油三酯血症。血浆游离肉碱水平较低，铜水平也低。补充肉碱后，神经状况迅速改善，代谢紊乱消退。长时间的CRRT可能会因微量营养素和微量元素的临床显著缺乏而变得复杂。
