Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position
Summary: Background: The prone position (PP) used in the treatment of critically ill patients infected with SARS-CoV-2, may be a barrier to enteral nutrition (EN). This study aimed to analyze the effectiveness and complications of EN in the PP, as well as clinical outcomes. Methods: Prospective coh...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Clinical Nutrition Open Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667268522000444 |
| _version_ | 1797990588631482368 |
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| author | Jéssica Alves de Paula Estela Iraci Rabito Sandra Regina Justino Luíza Silva Leite Danielle Dantas Jessica Sayume Makiyama da Silva Larissa Farinha Maffini Odery Ramos Júnior |
| author_facet | Jéssica Alves de Paula Estela Iraci Rabito Sandra Regina Justino Luíza Silva Leite Danielle Dantas Jessica Sayume Makiyama da Silva Larissa Farinha Maffini Odery Ramos Júnior |
| author_sort | Jéssica Alves de Paula |
| collection | DOAJ |
| description | Summary: Background: The prone position (PP) used in the treatment of critically ill patients infected with SARS-CoV-2, may be a barrier to enteral nutrition (EN). This study aimed to analyze the effectiveness and complications of EN in the PP, as well as clinical outcomes. Methods: Prospective cohort study with patients in EN and coronavirus disease 2019 (COVID-19), on mechanical ventilation (MV), which whom needed or not PP. Gastrointestinal intolerances (GII) related to PP were evaluated, and correlated with possible confounding factors. EN, days on MV, Intensive Care Unit (ICU) length of stay, hospital length of stay, ventilator-associated pneumonia (VAP) and mortality were analyzed. The data were evaluated daily and compared prone group (PG=57) and supine group (SG=69). Results: The PP was associated with GII (P=0.000) and presented in 32 patients (26,44%) with no difference among groups. Association between epinephrine (P=0.003), vasopressin (P=0.018), and GII was observed. There was no difference between the total volume of enteral nutrition (TVEN) infused in the groups. However, the mean EN infused for the days when the patient was on PP was (70.0% ± 31.5) and for the days in supine position was (74.8% ± 27.3), P= 0.006. The PG had a longer time on MV (P=0.005) and ICU (P=0.003) and PP was associated with VAP (P=<0.001). The infused TVEN showed no association with VAP (P=0.09). Conclusion: PP was a determining factor in GII and proved to be a risk factor for VAP, but the EN protocol seems to have ensured an adequate EN supply in PP and be a safe alternative. |
| first_indexed | 2024-04-11T08:39:03Z |
| format | Article |
| id | doaj.art-a40da78228d24930a2c2859f3d342eda |
| institution | Directory Open Access Journal |
| issn | 2667-2685 |
| language | English |
| last_indexed | 2024-04-11T08:39:03Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Nutrition Open Science |
| spelling | doaj.art-a40da78228d24930a2c2859f3d342eda2022-12-22T04:34:15ZengElsevierClinical Nutrition Open Science2667-26852022-10-01458090Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone positionJéssica Alves de Paula0Estela Iraci Rabito1Sandra Regina Justino2Luíza Silva Leite3Danielle Dantas4Jessica Sayume Makiyama da Silva5Larissa Farinha Maffini6Odery Ramos Júnior7Clinical Nutrition Unit, Clinical Hospital Complex – Federal University of Paraná, Curitiba-PR, Brazil; Corresponding author. Rua Odete Laura Foggiato, 104, casa 06, CEP 82630-040, Atuba, Curitiba-PR, Brazil.Department of Nutrition, Federal University of Paraná, Curitiba-PR, BrazilNutrition Department of the Brazilian Association of Intensive Care Medicine, São Paulo-SP, Brazil; Nutrition Department of the Intensive Care Society of Paraná Brazil, Curitiba-PR, BrazilClinical Nutrition Unit, Clinical Hospital Complex – Federal University of Paraná, Curitiba-PR, BrazilClinical Nutrition Unit, Clinical Hospital Complex – Federal University of Paraná, Curitiba-PR, BrazilClinical Nutrition Unit, Clinical Hospital Complex – Federal University of Paraná, Curitiba-PR, BrazilClinical Nutrition Unit, Clinical Hospital Complex – Federal University of Paraná, Curitiba-PR, BrazilDepartment of Internal Medicine, Gastroenterology Division, Clinical Hospital Complex – Federal University of Paraná, Curitiba-PR, BrazilSummary: Background: The prone position (PP) used in the treatment of critically ill patients infected with SARS-CoV-2, may be a barrier to enteral nutrition (EN). This study aimed to analyze the effectiveness and complications of EN in the PP, as well as clinical outcomes. Methods: Prospective cohort study with patients in EN and coronavirus disease 2019 (COVID-19), on mechanical ventilation (MV), which whom needed or not PP. Gastrointestinal intolerances (GII) related to PP were evaluated, and correlated with possible confounding factors. EN, days on MV, Intensive Care Unit (ICU) length of stay, hospital length of stay, ventilator-associated pneumonia (VAP) and mortality were analyzed. The data were evaluated daily and compared prone group (PG=57) and supine group (SG=69). Results: The PP was associated with GII (P=0.000) and presented in 32 patients (26,44%) with no difference among groups. Association between epinephrine (P=0.003), vasopressin (P=0.018), and GII was observed. There was no difference between the total volume of enteral nutrition (TVEN) infused in the groups. However, the mean EN infused for the days when the patient was on PP was (70.0% ± 31.5) and for the days in supine position was (74.8% ± 27.3), P= 0.006. The PG had a longer time on MV (P=0.005) and ICU (P=0.003) and PP was associated with VAP (P=<0.001). The infused TVEN showed no association with VAP (P=0.09). Conclusion: PP was a determining factor in GII and proved to be a risk factor for VAP, but the EN protocol seems to have ensured an adequate EN supply in PP and be a safe alternative.http://www.sciencedirect.com/science/article/pii/S2667268522000444COVID-19Prone positionEnteral nutrition |
| spellingShingle | Jéssica Alves de Paula Estela Iraci Rabito Sandra Regina Justino Luíza Silva Leite Danielle Dantas Jessica Sayume Makiyama da Silva Larissa Farinha Maffini Odery Ramos Júnior Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position Clinical Nutrition Open Science COVID-19 Prone position Enteral nutrition |
| title | Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position |
| title_full | Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position |
| title_fullStr | Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position |
| title_full_unstemmed | Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position |
| title_short | Administration of enteral nutrition and gastrointestinal complications in Covid-19 critical patients in prone position |
| title_sort | administration of enteral nutrition and gastrointestinal complications in covid 19 critical patients in prone position |
| topic | COVID-19 Prone position Enteral nutrition |
| url | http://www.sciencedirect.com/science/article/pii/S2667268522000444 |
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