[Nutritional support for critically ill patients with COVID-19]

Area of Science:

• Critical Care Medicine
• Clinical Nutrition
• Infectious Diseases

Background:

• Critically ill patients with COVID-19 experience high inflammation, stress, and catabolism, leading to increased energy demands.
• Effective nutritional support is crucial for managing these patients and improving outcomes.

Purpose of the Study:

• To summarize and provide suggestions on nutritional support strategies for critically ill COVID-19 patients.
• To offer guidance on individualized nutritional therapy based on metabolic characteristics and clinical status.

Main Methods:

• Nutritional risk screening using NRS-2002 or Nutric tool.
• Malnutrition assessment with Subjective Global Assessment (SGA) or Global Leadership Initiative on Malnutrition (GLIM).
• Selection of nutritional interventions (oral, enteral, parenteral) based on gastrointestinal function and clinical needs, with a preference for enteral nutrition in specific cases (prone ventilation, ECMO).

Main Results:

• Early nutritional risk screening and assessment are recommended for all critically ill COVID-19 patients.
• Individualized determination of energy, protein, electrolyte, and fluid requirements is essential.
• Enteral nutrition is the preferred route for patients with normal gastrointestinal function requiring prone position ventilation or ECMO.
• Close monitoring for adverse reactions and timely adjustment of nutrition plans are critical for successful implementation.

Conclusions:

• Personalized nutritional support, encompassing risk assessment, targeted interventions, and vigilant monitoring, is fundamental for critically ill COVID-19 patients.
• This approach aims to optimize patient recovery and mitigate complications associated with malnutrition and critical illness.