COVID-19 患者在重症监护病房中的营养支持演变。
Evolution of nutrition support in patients with COVID-19 disease admitted in the Intensive Care Unit.
机构信息
Servicio de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Centro de Investigación en Endocrinología y Nutrición, Universidad de Valladolid (IENVA), Valladolid, Spain.
Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
出版信息
Endocrinol Diabetes Nutr (Engl Ed). 2022 Dec;69(10):802-809. doi: 10.1016/j.endien.2022.11.029. Epub 2022 Nov 25.
INTRODUCTION
Nutritional support in patients with COVID19 can influence the mean stay and complications in the patient in Intensive Care Unit (ICU).
AIMS
To evaluate the selection of enteral nutritional treatment in the COVID-19 patient admitted to the ICU. To know the development of dysphagia and its treatment. To evaluate the adjustment to the requirements and its relationship with the patient's complications.
MATERIAL AND METHODS
One-center longitudinal retrospective study in 71 patients admitted to the ICU with COVID19 infection and complete enteral nutrition between March and April 2020. Clinical variables were collected: length of stay in ICU, mean stay and rate of complications; and estimated anthropometric variables.
RESULTS
The mean age was 61.84 (13.68) years. Among the patients analyzed, 33 (46.5%) died. The median stay in the ICU was 20 (15.75-32) days and the mean stay was 37 (26.75-63) days. The type of formula most prescribed was normoprotein 24 (35.3%) and diabetes-specific 23 (33.8%) depending on the prescribed formula. There was no difference in mean stay (p = 0.39) or death rate (p = 0.35). The percentage of achievement of the estimated protein requirements was 50 (34.38-68.76). At discharge, 8 (21%) of the patients had dysphagia. A relationship was observed between the mean ICU stay and the probability of developing dysphagia (OR: 1.035 (1.004-1.07); p = 0.02).
CONCLUSIONS
In the patient with COVID19 disease admitted to the ICU, only half of the necessary protein requirements were reached. The presence of dysphagia at discharge was related to the length of time the patient was in the ICU.
简介
COVID19 患者的营养支持可影响 ICU 患者的平均住院时间和并发症。
目的
评估 COVID-19 患者入住 ICU 时肠内营养治疗的选择。了解吞咽困难的发展及其治疗。评估对需求的调整及其与患者并发症的关系。
材料和方法
这是一项在 2020 年 3 月至 4 月期间因 COVID19 感染入住 ICU 并接受完全肠内营养的 71 例患者的单中心纵向回顾性研究。收集了临床变量：ICU 住院时间、平均住院时间和并发症发生率；并估计了人体测量学变量。
结果
患者的平均年龄为 61.84（13.68）岁。在分析的患者中，有 33 人（46.5%）死亡。ICU 中位住院时间为 20（15.75-32）天，平均住院时间为 37（26.75-63）天。根据处方配方，最常开的配方类型是标准蛋白 24（35.3%）和糖尿病专用 23（33.8%）。平均住院时间（p = 0.39）或死亡率（p = 0.35）无差异。估计蛋白质需求的达标率为 50（34.38-68.76）。出院时，有 8（21%）例患者存在吞咽困难。ICU 平均住院时间与发生吞咽困难的概率呈正相关（OR：1.035（1.004-1.07）；p = 0.02）。
结论
在 COVID19 疾病入住 ICU 的患者中，只有一半达到了所需的蛋白质需求。出院时存在吞咽困难与患者在 ICU 停留时间有关。
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