PMID- 36216665
OWN - NLM
STAT- MEDLINE
DCOM- 20221206
LR  - 20230125
IS  - 1532-1983 (Electronic)
IS  - 0261-5614 (Print)
IS  - 0261-5614 (Linking)
VI  - 41
IP  - 12
DP  - 2022 Dec
TI  - Nutrition support practices across the care continuum in a single centre critical 
      care unit during the first surge of the COVID-19 pandemic - A comparison of 
      VV-ECMO and non-ECMO patients.
PG  - 2887-2894
LID - S0261-5614(22)00321-1 [pii]
LID - 10.1016/j.clnu.2022.08.027 [doi]
AB  - BACKGROUND & AIMS: Critically ill patients with COVID-19 are at high nutrition 
      risk. This study aimed to describe the nutrition support practices in a single 
      centre critical care unit during the initial surge of the COVID-19 pandemic. 
      Practices were explored from ICU admission to post-ICU follow-up clinic and 
      patients who received veno-venous extra-corporeal membrane oxygenation (VV-ECMO) 
      were compared to those who did not. METHODS: This retrospective observational 
      study included COVID-19 positive, adult ICU patients who were mechanically 
      ventilated for >/=72 h. Data were collected from ICU admission until the time of 
      post-ICU clinic. For in-ICU data, results are compared between patients who did 
      and did not receive VV-ECMO. RESULTS: 252 patients were included (VV-ECMO 
      n = 58). Adequate energy and protein was delivered in 193 (76.6%) patients during 
      their ICU admission with no differences between those who did and did not receive 
      VV-ECMO (44 (75.9%) vs. 149 (76.8%)). Parenteral nutrition only being required in 
      12 (4.8%) patients. Following stepdown to the ward 77 (70%) patients required 
      ongoing enteral nutrition support, and 74 (66.7%) required a texture modified 
      diet or were NBM. Following hospital discharge, nearly a third of ICU survivors 
      (28.4%) were referred for dietetic input. The most common referral reason was 
      loss of weight. Breathlessness and fatigue were the most commonly reported 
      nutrition impact symptoms experienced following hospital discharge. CONCLUSION: 
      Results show it is possible to reach nutritional adequacy for most patients and 
      that neither VV-ECMO nor proning were barriers to nutritional adequacy. 
      Nutritional issues for patients who were critically ill with COVID-19 persist 
      following stepdown to ward level and into the community and strategies to manage 
      this require further investigation.
CI  - Crown Copyright (c) 2022. Published by Elsevier Ltd. All rights reserved.
FAU - Hardy, Georgia
AU  - Hardy G
AD  - Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, 
      London UK; Department of Critical Care, Guy's and St Thomas' NHS Foundation 
      Trust, London UK.
FAU - Camporota, Luigi
AU  - Camporota L
AD  - Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London 
      UK.
FAU - Bear, Danielle E
AU  - Bear DE
AD  - Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, 
      London UK; Department of Critical Care, Guy's and St Thomas' NHS Foundation 
      Trust, London UK. Electronic address: Danielle.Bear@gstt.nhs.uk.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20220910
PL  - England
TA  - Clin Nutr
JT  - Clinical nutrition (Edinburgh, Scotland)
JID - 8309603
SB  - IM
MH  - Adult
MH  - Humans
MH  - *COVID-19/epidemiology/therapy
MH  - Critical Illness/therapy
MH  - Pandemics
MH  - Intensive Care Units
MH  - Patient Discharge
MH  - Retrospective Studies
MH  - Critical Care/methods
PMC - PMC9463074
OTO - NOTNLM
OT  - ARDS
OT  - COVID-19
OT  - Critical care
OT  - ECMO
OT  - Enteral feeding
OT  - Nutrition
COIS- Conflict of interest GH received conference registration fees from Nutricia Ltd. 
      LC has no conflicts of interest to declare. DEB has received speaker fees from 
      Baxter Healthcare.
EDAT- 2022/10/11 06:00
MHDA- 2022/12/07 06:00
PMCR- 2022/09/10
CRDT- 2022/10/10 22:05
PHST- 2022/06/14 00:00 [received]
PHST- 2022/08/14 00:00 [revised]
PHST- 2022/08/29 00:00 [accepted]
PHST- 2022/10/11 06:00 [pubmed]
PHST- 2022/12/07 06:00 [medline]
PHST- 2022/10/10 22:05 [entrez]
PHST- 2022/09/10 00:00 [pmc-release]
AID - S0261-5614(22)00321-1 [pii]
AID - 10.1016/j.clnu.2022.08.027 [doi]
PST - ppublish
SO  - Clin Nutr. 2022 Dec;41(12):2887-2894. doi: 10.1016/j.clnu.2022.08.027. Epub 2022 
      Sep 10.