Nutritional Care in Relation to COVID-19

Area of Science:

• Critical Care Medicine
• Clinical Nutrition
• Infectious Diseases

Background:

• The initial COVID-19 pandemic wave impacted intensive care unit (ICU) practices.
• Subjective observations indicated significant weight loss in ventilated patients.
• Nutritional support is crucial for critically ill patients.

Purpose of the Study:

• To retrospectively audit enteral nutrition delivery in ICU patients during the COVID-19 pandemic.
• To identify factors hindering adequate feed delivery.
• To propose improvements for future pandemic waves.

Main Methods:

• Retrospective audit of prescribed versus delivered enteral feed volumes.
• Analysis of reasons for underfeeding, including patient positioning and gastric residual volumes.
• Review of clinical practice against established guidelines.

Main Results:

• Only 10% of ICU admissions received their prescribed daily feed volume within the first 7 days.
• An additional 6% were within 10% of target volumes.
• Key barriers included patient proning, high gastric residuals, and pandemic-related pressures.

Conclusions:

• Current enteral feeding practices were insufficient for critically ill COVID-19 patients.
• Recommendations include establishing a dedicated nasojejunal feeding team.
• Adjusted feeding protocols for proned patients and revised adherence to hypocaloric feeding guidelines are proposed.