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- Title
Inadequate Energy Delivery Is Frequent among COVID-19 Patients Requiring ECMO Support and Associated with Increased ICU Mortality.
- Authors
Schneeweiss-Gleixner, Mathias; Scheiner, Bernhard; Semmler, Georg; Maleczek, Mathias; Laxar, Daniel; Hintersteininger, Marlene; Hermann, Martina; Hermann, Alexander; Buchtele, Nina; Schaden, Eva; Staudinger, Thomas; Zauner, Christian
- Abstract
Background: Patients receiving extracorporeal membrane oxygenation (ECMO) support are at high risk for malnutrition. There are currently no general nutrition guidelines for coronavirus disease 2019 (COVID-19) patients during ECMO therapy. Methods: We conducted a retrospective analysis of COVID-19 patients requiring venovenous ECMO support at a large tertiary hospital center. Nutrition goals were calculated using 25 kcal/kg body weight (BW)/day. Associations between nutrition support and outcome were evaluated using Kaplan–Meier and multivariable Cox regression analyses. Results: Overall, 102 patients accounted for a total of 2344 nutrition support days during ECMO therapy. On 40.6% of these days, nutrition goals were met. Undernutrition was found in 40.8%. Mean daily calorie delivery was 73.7% of calculated requirements, mean daily protein delivery was 0.7 g/kg BW/d. Mean energy intake of ≥70% of calculated targets was associated with significantly lower ICU mortality independently of age, disease severity at ECMO start and body mass index (adjusted hazard ratio: 0.372, p = 0.007). Conclusions: Patients with a mean energy delivery of ≥70% of calculated targets during ECMO therapy had a better ICU survival compared to patients with unmet energy goals. These results indicate that adequate nutritional support needs to be a major priority in the treatment of COVID-19 patients requiring ECMO support.
- Subjects
INTENSIVE care units; COVID-19; FOOD consumption; EXTRACORPOREAL membrane oxygenation; ACQUISITION of data; RETROSPECTIVE studies; TERTIARY care; DIET therapy; HOSPITAL mortality; MALNUTRITION; MEDICAL records; KAPLAN-Meier estimator; DESCRIPTIVE statistics; PROPORTIONAL hazards models
- Publication
Nutrients, 2023, Vol 15, Issue 9, p2098
- ISSN
2072-6643
- Publication type
Article
- DOI
10.3390/nu15092098