Clinical nutrition ESPEN
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Clinical nutrition ESPEN · Dec 2020
Prevalence of obesity and hypovitaminosis D in elderly with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Verify the prevalence of hypovitaminosis D and obesity in elderly patients infected by new coronavirus. The patients developed severe symptoms and were admitted in intensive care unit (ICU) to receive invasive ventilation due to diagnosis of acute respiratory distress syndrome (ARDS). ⋯ Hypovitaminosis D and obesity in elderly have a high prevalence in critically ill patients in ICU infected by the new coronavirus. Laboratory investigation of vitamin D becomes important, especially in obese elderly patients.
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Clinical nutrition ESPEN · Oct 2020
Resting energy expenditure by indirect calorimetry versus the ventilator-VCO2 derived method in critically ill patients: The DREAM-VCO2 prospective comparative study.
Both overfeeding and underfeeding of intensive care unit (ICU) patients are associated with worse outcomes. Predictive equations of nutritional requirements, though easily implemented, are highly inaccurate. Ideally, the individual caloric target is based on the frequent assessment of energy expenditure (EE). Indirect calorimetry is considered the gold standard but is not always available. EE estimated by ventilator-derived carbon dioxide consumption (EEVCO2) has been proposed as an alternative to indirect calorimetry, but there is limited evidence to support the use of this method. ⋯ EEVCO2, compared with indirect calorimetry, overestimates actual energy expenditure. Although the reliability is acceptable, bias is significant, and the precision and accuracy rates are unacceptably low when the VCO2 method is used. Including the food quotient into the EEVCO2 equation does not improve its performance. Predictive equations, although inaccurate, may even predict energy expenditure better compared with the VCO2-method. Indirect calorimetry remains the gold standard method.
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Clinical nutrition ESPEN · Oct 2020
Observational StudyAccuracy and reliability of a portable indirect calorimeter compared to whole-body indirect calorimetry for measuring resting energy expenditure.
Resting energy expenditure (REE) is the largest component of total energy expenditure. As such, inaccurate estimation or measurement of REE may impact the development of individualized energy intake recommendations. The objective of this observational study was to assess the accuracy and reliability of REE measured with a portable indirect calorimeter with ventilated hood - Fitmate GS - compared to REE from whole-body indirect calorimetry (WBC). ⋯ The Fitmate GS did not accurately quantify REE but produced reliable REE measurements.
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Clinical nutrition ESPEN · Oct 2020
Easy-to-prescribe nutrition support in the intensive care in the era of COVID-19.
COVID-19 pandemic had resulted in a massive increase in the number of patients admitted to intensive care units (ICUs). This created significant organizational challenges including numerous non-specialist ICU caregivers who came to work in the ICU. In this context, pragmatic protocols were essential to simplify nutritional care. We aimed at providing a simple and easy-to-prescribe nutritional protocol and evaluated its usefulness with questionnaires sent to physicians involved in the care of ICU COVID-19 patients. ⋯ Nutritional therapy in critically ill COVID-19 patients is a challenge and the implementation of this specific pandemic simplified nutritional protocol was assessed as useful by a great majority of physicians. Pragmatic and simplified protocols are useful for ensuring the quality of nutritional therapy and could be used in future studies to assess its actual impact on the clinical outcomes of COVID-19 patients.