Departamento de Anestesiología y Cuidados Críticos, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
Departamento de Anestesiología y Cuidados Críticos, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
Rev Esp Anestesiol Reanim (Engl Ed). 2023 Aug-Sep;70(7):387-394. doi: 10.1016/j.redare.2022.11.002. Epub 2023 Aug 6.
The critical patient affected by SARS-CoV-2 is at risk of malnutrition. The need to avoid volume overload and manoeuvres that delay reaching nutritional requirements such as pronation make the nutritional approach to these patients complex. To ensure adequate treatment, a nutritional support protocol was developed as a clinical practice guideline adapted to the COVID-19 patient.
To describe and analyse the results of introducing a nutritional support protocol aimed at SARS-CoV-2 patients admitted to the intensive care unit (ICU) of the Consorcio Hospital General Universitario de Valencia (CHGUV) from March to May 2020.
Observational, descriptive, retrospective and longitudinal design to evaluate compliance with a nutritional support protocol.
Thirty-one consecutive patients were included but nutritional follow-up could not be performed in eight. Of the remaining 23 patients, only eight reached 80% of caloric requirements before the tenth day after starting treatment (good compliance group) and 15 after the eleventh day (poor compliance group). In the group with «good compliance» 75% (n=6) were discharged and 25% died (n=2), compared to the group with «bad compliance» where 53% (n=8) were discharged and 47% (n=7) died (Chi square test, p-value=0.019). Those patients who reached 80% of caloric needs during ICU stay had a shorter length of stay compared to those who did not (median days of admission=14, IQR=10-16 and median days of admission=22, IQR=13-39, p-value=0.025).
Introducing a nutritional protocol during the first weeks of the SARS-CoV-2 pandemic could improve clinical outcomes by promoting healing and reducing associated complications.
感染 SARS-CoV-2 的危重症患者存在营养不良风险。为避免容量超负荷和延迟满足营养需求的操作（如旋前），这些患者的营养治疗方法变得复杂。为确保充分治疗，我们制定了营养支持方案作为适应 COVID-19 患者的临床实践指南。
描述并分析 2020 年 3 月至 5 月期间向 Consorcio Hospital General Universitario de Valencia（CHGUV）重症监护病房（ICU）收治的 SARS-CoV-2 患者引入营养支持方案的结果。
采用观察性、描述性、回顾性和纵向设计，评估营养支持方案的依从性。
共纳入 31 例连续患者，但有 8 例无法进行营养随访。在其余 23 例患者中，只有 8 例在开始治疗后第 10 天前达到 80%的热量需求（良好依从性组），15 例在第 11 天后（依从性差组）。在「良好依从性」组中，75%（n=6）出院，25%死亡（n=2），而在「不良依从性」组中，53%（n=8）出院，47%（n=7）死亡（卡方检验，p 值=0.019）。与未达到 80%热量需求的患者相比，在 ICU 期间达到 80%热量需求的患者住院时间更短（中位数住院天数=14，IQR=10-16 和中位数住院天数=22，IQR=13-39，p 值=0.025）。
在 SARS-CoV-2 大流行的最初几周内引入营养方案可以通过促进愈合和减少相关并发症来改善临床结果。
