Nutrition support practices for critically ill patients with severe acute respiratory syndrome coronavirus-2: A multicentre observational study in Singapore.
10.47102/annals-acadmedsg.202231
- Author:
Charles Chin Han LEW
1
;
Puay Shi NG
;
Kok Wah WONG
;
Ser Hon PUAH
;
Cassandra Duan Qi LIM
;
Geetha KAYAMBU
;
Andrew Yunkai LI
;
Chee Hong TOH
;
Jonathen VENKATACHALAM
;
Amartya MUKHOPADHYAY
Author Information
1. Dietetics and Nutrition Department, Ng Teng Fong General Hospital, Singapore.
- Publication Type:Observational Study
- MeSH:
COVID-19/therapy*;
Critical Illness/therapy*;
Humans;
Nutritional Support;
SARS-CoV-2;
Singapore/epidemiology*;
United States
- From:Annals of the Academy of Medicine, Singapore
2022;51(6):329-340
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:To improve the nutritional care and resource allocation of critically ill patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), we described their characteristics, treatment modalities and clinical outcomes, and compared their nutrition interventions against the American Society for Parenteral and Enteral Nutrition (ASPEN) recommendations.
METHODS:This was a retrospective observational study conducted in 5 tertiary hospitals in Singapore. Characteristics, treatment modalities, clinical outcomes and nutrition interventions of critically ill patients with SARS-CoV-2 who received enteral and parenteral nutrition were collected between January and May 2020.
RESULTS:Among the 83 critically ill patients with SARS-CoV-2, 22 (28%) were obese, 45 (54%) had hypertension, and 21 (25%) had diabetes. Neuromuscular blockade, prone therapy and dialysis were applied in 70% (58), 47% (39) and 35% (29) of the patients, respectively. Refeeding hypophosphataemia and hospital mortality occurred respectively in 6% (5) and 18% (15) of the critically ill patients with SARS-CoV-2. Late enteral nutrition and cardiovascular comorbidities were associated with higher hospital mortality (adjusted relative risk 9.00, 95% confidence interval [CI] 2.25-35.99; 6.30, 95% CI 1.15-34.40, respectively). Prone therapy was not associated with a higher incidence of high gastric residual volume (≥250mL). The minimum caloric (15kcal/kg) and protein (1.2g/kg) recommendations of ASPEN were achieved in 54% (39) and 0% of the patients, respectively.
CONCLUSION:The high obesity prevalence and frequent usage of neuromuscular blockade, prone therapy, and dialysis had considerable implications for the nutritional care of critically ill patients with SARS-CoV-2. They also did not receive adequate calories and protein. More audits should be conducted to refine nutritional interventions and guidelines for this ever-evolving disease.
