Nutrition Therapy in Critically Ill Patients With Coronavirus Disease 2019.
Robert G. Martindale,Jayshil J. Patel,Beth Taylor,Yaseen M. Arabi,Malissa Warren,Stephen A. McClave +5 more
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TLDR
Clinicians should have a lower threshold for switching to parenteral nutrition in cases of intolerance, high risk of aspiration, or escalating vasopressor support, and the lack of demonstrated benefit precludes a recommendation for micronutrient supplementation.Abstract:
In the midst of a coronavirus disease 2019 (COVID-19) pandemic, a paucity of data precludes derivation of COVID-19-specific recommendations for nutrition therapy. Until more data are available, focus must be centered on principles of critical care nutrition modified for the constraints of this disease process, ie, COVID-19-relevant recommendations. Delivery of nutrition therapy must include strategies to reduce exposure and spread of disease by providing clustered care, adequate protection of healthcare providers, and preservation of personal protective equipment. Enteral nutrition (EN) should be initiated early after admission to the intensive care unit (ICU) using a standard isosmolar polymeric formula, starting at trophic doses and advancing as tolerated, while monitoring for gastrointestinal intolerance, hemodynamic instability, and metabolic derangements. Intragastric EN may be provided safely, even with use of prone-positioning and extracorporeal membrane oxygenation. Clinicians should have a lower threshold for switching to parenteral nutrition in cases of intolerance, high risk of aspiration, or escalating vasopressor support. Although data extrapolated from experience in acute respiratory distress syndrome warrants use of fiber additives and probiotic organisms, the lack of benefit precludes a recommendation for micronutrient supplementation. Practices that increase exposure or contamination of equipment, such as monitoring gastric residual volumes, indirect calorimetry to calculate requirements, endoscopy or fluoroscopy to achieve enteral access, or transport out of the ICU for additional imaging, should be avoided. At all times, strategies for nutrition therapy need to be assessed on a risk/benefit basis, paying attention to risk for both the patient and the healthcare provider.read more
Citations
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COVID-19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative (ADQI) Workgroup.
Mitra K. Nadim,Lui G. Forni,Lui G. Forni,Ravindra L. Mehta,Michael J. Connor,Kathleen D. Liu,Marlies Ostermann,Thomas Rimmelé,Alexander Zarbock,Samira Bell,Azra Bihorac,Vincenzo Cantaluppi,Eric Hoste,Faeq Husain-Syed,Michael J. Germain,Stuart L. Goldstein,Shruti Gupta,Michael Joannidis,Kianoush Kashani,Jay L. Koyner,Matthieu Legrand,Nuttha Lumlertgul,Sumit Mohan,Neesh Pannu,Zhiyong Peng,Xose L. Perez-Fernandez,Peter Pickkers,John R. Prowle,Thiago Reis,Nattachai Srisawat,Nattachai Srisawat,Ashita Tolwani,Anitha Vijayan,Gianluca Villa,Li Yang,Claudio Ronco,John A. Kellum +36 more
TL;DR: This Consensus Statement from the Acute Disease Quality Initiative provides recommendations for the diagnosis, prevention and management of COVID-19 AKI and for areas of future research, with the aim of improving understanding of the underlying processes and outcomes for patients with CO VID- 19 AKI.
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Permissive Underfeeding or Standard Enteral Feeding in Critically Ill Adults
TL;DR: Hedeflenen kaloriye ulaşılması ile protein katabolizması ve malnutrisyonun iyileştirilmesi ve bununla ilişkili morbidite ve mortalitede azalma amaçlanmaktadır bakımında önemlidir.
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SARS-CoV-2 microbiome dysbiosis linked disorders and possible probiotics role.
Ahmad Ud Din,Maryam Mazhar,Muhammed Waseem,Waqar Ahmad,Asma Bibi,Adil Hassan,Niaz Ali,Wang Gang,Gao Qian,Razi Ullah,Tariq Shah,Mehraj Ullah,Israr Khan,Muhammad Farrukh Nisar,Jianbo Wu +14 more
TL;DR: It is concluded that dysbiosis occurs during SARS-COV-2 infection as the gut-lung axis cannot be ignored and the inclusion of studies to investigate gut microbiome and subsequent therapies such as probiotics might help decrease the inflammatory response of viral pathogenesis and respiratory symptoms by strengthening the host immune system, amelioration of gut microbiome, and improvement of gut barrier function.
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The Role of Nutrition in COVID-19 Susceptibility and Severity of Disease: A Systematic Review.
Philip T. James,Zakari Ali,Andrew E. Armitage,Ana Bonell,Carla Cerami,Hal Drakesmith,Modou Jobe,Kerry S Jones,Zara Liew,Sophie E. Moore,Sophie E. Moore,Fernanda Morales-Berstein,Helen M. Nabwera,Behzad Nadjm,Sant-Rayn Pasricha,Sant-Rayn Pasricha,Pauline Scheelbeek,Matt J. Silver,Megan R Teh,Andrew M. Prentice +19 more
TL;DR: In this article, the authors reviewed the latest evidence on how malnutrition across all its forms (under-and overnutrition and micronutrient status) may influence both susceptibility to, and progression of, COVID-19.
Journal ArticleDOI
Clinical Nutrition Research and the COVID-19 Pandemic: A Scoping Review of the ASPEN COVID-19 Task Force on Nutrition Research.
Jeffrey I. Mechanick,Salvatore Carbone,Roland N. Dickerson,Beverly Hernandez,Ryan T. Hurt,Sharon Y. Irving,Ding You Li,Mary McCarthy,Kris M. Mogensen,Juan B Ochoa Gautier,Jayshil J. Patel,T. Elaine Prewitt,Martin D. Rosenthal,Malissa Warren,Marion F. Winkler,Liam McKeever +15 more
TL;DR: Multiple critical areas for urgent nutrition research, particularly using RCT design, to improve nutritional care for patients before, during, and after COVID-19 are identified.
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TL;DR: These guidelines offer basic recommendations that are supported by review and analysis of the current literature, other national and international guidelines, and a blend of expert opinion and clinical practicality that are directed toward generalized patient populations.
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