Energy requirements of long-term ventilated COVID-19 patients with resolved SARS-CoV-2 infection

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

Abstract

BACKGROUND & AIMS: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can rapidly progress into acute respiratory distress syndrome accompanied by multi-organ failure requiring invasive mechanical ventilation and critical care treatment. Nutritional therapy is a fundamental pillar in the management of hospitalized patients. It is broadly acknowledged that overfeeding and underfeeding of intensive care unit (ICU) patients are associated with increased morbidity and mortality. This study aimed to assess the energy demands of long-term ventilated COVID-19 patients using indirect calorimetry and to evaluate the applicability of established predictive equations to estimate their energy expenditure.

METHODS: We performed a retrospective, single-center study in 26 mechanically ventilated COVID-19 patients with resolved SARS-CoV-2 infection in three independent intensive care units. Resting energy expenditure (REE) was evaluated by repetitive indirect calorimetry (IC) measurements. Simultaneously the performance of 12 predictive equations was examined. Patient's clinical data were retrieved from electronic medical charts. Bland-Altman plots were used to assess agreement between measured and calculated REE.

RESULTS: Mean mREE was 1687 kcal/day and 20.0 kcal relative to actual body weight (ABW) per day (kcal/kg/day). Longitudinal mean mREE did not change significantly over time, although mREE values had a high dispersion (SD of mREE ±487). Obese individuals were found to have significantly increased mREE, but lower energy expenditure relative to their body mass. Calculated REE showed poor agreement with mREE ranging from 33 to 54%.

CONCLUSION: Resolution of SARS-CoV-2 infection confirmed by negative PCR leads to stabilization of energy demands at an average 20 kcal/kg in ventilated critically ill patients. Due to high variations in mREE and low agreement with calculated energy expenditure IC remains the gold standard for the guidance of nutritional therapy.

Details

OriginalspracheEnglisch
Seiten (von - bis)211-217
Seitenumfang7
FachzeitschriftClinical Nutrition ESPEN : official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN)
Jahrgang44
PublikationsstatusVeröffentlicht - Aug. 2021
Peer-Review-StatusJa

Externe IDs

PubMedCentral PMC8238638
Scopus 85109857174
ORCID /0000-0002-5329-3164/work/147141090
ORCID /0000-0003-3953-3253/work/147143174

Schlagworte

Schlagwörter

  • COVID-19/physiopathology, Calorimetry, Indirect, Critical Care/methods, Critical Illness, Energy Metabolism/physiology, Female, Humans, Male, Middle Aged, Nutritional Requirements/physiology, Respiration, Artificial/methods, Retrospective Studies, SARS-CoV-2, Time