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Accepted manuscript

Effectiveness and tolerance of enteral nutrition in critically ill patients with COVID-19

Published online by Cambridge University Press:  05 November 2024

Elizabeth Pérez-Cruz*
Affiliation:
Department Metabolic Unit and Nutritional Support, Hospital Juárez de México, México City. Obesity Clinic, Hospital Juárez de México, México City. National Autonomous University of Mexico, México City.
Salvador Ortiz-Gutiérrez
Affiliation:
Department Metabolic Unit and Nutritional Support, Hospital Juárez de México, México City. Obesity Clinic, Hospital Juárez de México, México City.
Jorge Alberto Castañón-González
Affiliation:
National Autonomous University of Mexico, México City. Department Adult Intensive Care Unit, Hospital Juárez de México, México City.
Yuritzy Luna-Camacho
Affiliation:
Department Metabolic Unit and Nutritional Support, Hospital Juárez de México, México City. Obesity Clinic, Hospital Juárez de México, México City.
Jessica Garduño-López
Affiliation:
National Autonomous University of Mexico, México City. Department Adult Intensive Care Unit, Hospital Juárez de México, México City.
*
Corresponding author: Elizabeth Pérez-Cruz, MD, MSc, Prof. Av. Instituto Politécnico Nacional Núm. 5160, Col. Magdalena de las Salinas, C.P. 07760, Del Gustavo A. Madero, México City, México. (+52) 5557477560 Ext 7497. E-mail: [email protected].
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Abstract

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This study compared the efficacy and tolerability of three enteral formulas in critically ill patients with COVID-19 who were ventilated and prone position. Enteral formulas: a) immunomodulatory (IMM), b) ω3 (ω3) and c) maltodextrins (MD). Primary outcome was percentage of patients who received both 80% of their protein and calorie targets at 3 days after enrolment. Secondary, mechanical ventilation-free time (MVF), ICU mortality, and markers of nutritional status. Tolerance of enteral nutrition (EN) was evaluated by diarrhea and gastroparesis rate. 231 patients were included, primary outcome achieved was in ω3 group (76.5% vs 59.7% and 35.2%, p < 0.001) vs IMM and MD groups. MVF were longer in ω3 and MD groups 23.11 ± 34.2 hours and 22.59 ± 42.2 hours vs IMM group 7.9 ± 22.6 hours (p < 0.01). Prealbumin final was 20.3 ± 10.8 mg/dL and 20.3 ± 9.5 mg/dL in IMM and ω3 groups vs 16.4 ± 7.0 mg/dL (p < 0.01) MD group. Transferrin were 151.5 ± 53.6 mg/dL and 152.1 ± 50.0 mg/dL in IMM and ω3 groups vs 133.7 ± 48.3 mg/dL (p < 0.05) MD group. Increase of lymphocytes was greater in ω3 1056.7 ± 660.8 cells/mm3 vs 853.3 ± 435.9 cells/mm3 and 942.7 ± 675.4 cells/mm3 (p < 0.001) IMM and MD groups. Diarrhea and gastroparesis occurred in 5.1% and 3.4% respectively. The findings of this study indicate that EN is a safe and well-tolerated intervention. The ω3 formula compared to IMM and MD did improve protein and calorie targets.

Type
Research Article
Copyright
© The Authors 2024