Skip to main content Skip to main navigation menu Skip to site footer
Review
Published: 07-03-2022

The Time for Parenteral Nutrition is Now: 12 Months Caring for Patients with Severe COVID-19

Medicine Course, Universidade de Uberaba, Uberaba, MG, Brazil
covid-19 critical care enteral nutrition nutrology parenteral nutrition supplemental parenteral nutrition

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has brought new challenges to adequate nutrition, especially in critically ill patients. Physicians caring for these patients face great difficulties, including a different pathophysiology compared with other diseases, inadequately trained personnel, pressure from the media and family members, logistical and economic obstacles, and lack of robust medical evidence. Although the literature on COVID-19 is still limited, evidence demonstrates the need to reevaluate the use of effective nutritional support in this unprecedented, challenging clinical context. Supplemental parenteral nutrition must be considered due to the energy expenditure from COVID-19, the difficulty in achieving protein and energy goals in patients under enteral nutrition in prone position, and the worsened gastroparesis related to high doses of sedative/neuromuscular blocking agents.

Metrics

Metrics Loading ...

References

  1. Richardson S, Hirsch JS, Narasimhan M. et al; the Northwell COVID-19 Research Consortium. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with Covid-19 in the New York city area. JAMA 2020; 323 (20) 2052-2059
  2. Calder PC. Nutrition, immunity and COVID-19. BMJ Nutrition. Prevent Health 2020; 3: e000085
  3. Martindale R, Patel JJ, Taylor B, Arabi YM, Warren M, McClave SA. Nutrition Therapy in Critically Ill Patients With Coronavirus Disease 2019. JPEN J Parenter Enteral Nutr 2020; 44 (07) 1174-1184
  4. Daher W, Godoy MF. Intuição, Evidência e Caos: Os Sinuosos Caminhos do Fato Científico. 1ª ed.. São José do Rio Preto (SP): Vitrine Literária Editora; 2012
  5. Yu P-J. et al. Hypermetabolism and COVID-19. J Parent Enter Nutr 2019
  6. Gattinoni L, Coppola S, Cressoni M, Busana M, Rossi S, Chiumello D. COVID-19 Does Not Lead to a “Typical” Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med 2020; 201 (10) 1299-1300
  7. Kiiski R, Takala J. Hypermetabolism and efficiency of CO2 removal in acute respiratory failure. Chest 1994; 105 (04) 1198-1203
  8. Barazzoni R, Bischoff SC, Breda J. et al; endorsed by the ESPEN Council. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr 2020; 39 (06) 1631-1638
  9. Singer P, Pichard C, De Waele E. Practical guidance for the use of indirect calorimetry during COVID 19 pandemic. Clin Nutr Exp 2020; 33: 18-23
  10. Whittle J, Molinger J, MacLeod D, Haines K, Wischmeyer PE. LEEP-COVID Study Group. Persistent hypermetabolism and longitudinal energy expenditure in critically ill patients with COVID-19. Crit Care 2020; 24 (01) 581
  11. Saez de la Fuente I, Saez de la Fuente J, Quintana Estelles MD. et al. Enteral nutrition in patients receiving mechanical ventilation in a prone position. JPEN J Parenter Enteral Nutr 2016; 40 (02) 250-255
  12. Singer P, Blaser AR, Berger MM. et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 2019; 38 (01) 48-79
  13. Hanidziar D, Bittner EA. Sedation of Mechanically Ventilated COVID-19 Patients: Challenges and Special Considerations. Anesth Analg 2020; 131 (01) e40-e41
  14. Martyn JAJ, Mao J, Bittner EA. Opioid tolerance in critical illness. N Engl J Med 2019; 380 (04) 365-378
  15. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Accessed [August 15th, 2020] at https://www.covid19treatmentguidelines.nih.gov/
  16. Bhatraju PK, Ghassemieh BJ, Nichols M. et al. COVID-19 in critically ill patients in the Seattle region - case series. N Engl J Med 2020; 382 (21) 2012-2022
  17. El Moheb M, Naar L, Christensen MA. et al. Gastrointestinal Complications in Critically Ill Patients With and Without COVID-19. JAMA 2020; DOI: 10.1001/jama.2020.19400.
  18. McClave SA, Martindale RG. Why do current strategies for optimal nutritional therapy neglect the microbiome?. Nutrition 2019; 60: 100-105
  19. Patel JJ, Martindale RG, McClave SA. Relevant Nutrition Therapy in COVID-19 and the Constraints on Its Delivery by a Unique Disease Process. Nutr Clin Pract 2020; 35 (05) 792-799
  20. Cuerda C. et al. Nutritional treatment in critically ill patients with COVID-19 disease: Spanish experience in a university hospital (extended). In: ESPEN Virtual Congress on Clinical Nutrition & Metabolism 2020, Lyon. Annals. Clinical Nutrition ESPEN 2020(12):629
  21. Koekkoek KWAC, van Zanten ARH. Nutrition in the ICU: new trends versus old-fashioned standard enteral feeding?. Curr Opin Anaesthesiol 2018; 31 (02) 136-143
  22. Reignier J, Boisramé-Helms J, Brisard L. et al; NUTRIREA-2 Trial Investigators, Clinical Research in Intensive Care and Sepsis (CRICS) group. Enteral versus parenteral early nutrition in ventilated adults with shock: a randomised, controlled, multicentre, open-label, parallel-group study (NUTRIREA-2). Lancet 2018; 391 (10116): 133-143
  23. Barbosa CL. et al. Infectious complications after insertion of peripheral or central venous catheters in patients on parenteral nutrition. In: ESPEN Virtual Congress on Clinical Nutrition & Metabolism 2020, Lyon. Annals. Clinical Nutrition ESPEN 2020; (12) 629

How to Cite

Barbosa, C. de L. (2022). The Time for Parenteral Nutrition is Now: 12 Months Caring for Patients with Severe COVID-19. International Journal of Nutrology, 14(1), 21–25. https://doi.org/10.1055/s-0041-1728679