Energy expenditure and feeding practices and tolerance during the acute and late phase of critically ill COVID-19 patients

Different metabolic phases can be distinguished in critical illness, which influences nutritional treatment. Achieving optimal nutritional treatment during these phases in critically ill patients is challenging.

The aim of this observational study is to describe measured resting energy expenditure (mREE) and feeding practices and tolerance during the acute and late phases of critical illness in COVID-19 patients; mREE was determined with an indirect calorimeter (Q-NRG+, COSMED, Italy) and performed preferably on day 4 and 10 of ICU admission.

No significant difference in measured energy expenditure between the acute and late phase of critical illness was observed. However, in both phases the majority of the patients were hypermetabolic and fed below mREE.

In conjunction with an increasing loss of nitrogen in the late phase and a negative nitrogen balance it can be concluded that patients remained in a prolonged catabolic phase. Based on the results the need for indirect calorimetry to guide nutritional treatment in COVID-19 patients should be emphasized since predictive formulas underestimated REE.

Article details:

- Title: Energy expenditure and feeding practices and tolerance during the acute and late phase of critically ill COVID-19 patients
- Authors: P.L.M. Lakenman, B. Van der Hoven, J.M. Schuijs, J. van Bommel, J.F. Olieman, K.F.M. Joosten et al.
- Published in: Clinical Nutrition ESPEN - 01 April 2021
- Link: https://doi.org/10.1016/j.clnesp.2021.03.019