Inadequate Energy Delivery Is Frequent among COVID-19 Patients Requiring ECMO Support and Associated with Increased ICU Mortality

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. We conducted a retrospective analysis of COVID-19 patients requiring veno...

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Published in:Nutrients 2023-04, Vol.15 (9), p.2098
Main 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
Format: Article
Language:English
Subjects:
Analysis
Body mass
Body mass index
Body size
Body weight
Calories
Coronaviruses
COVID-19
COVID-19 - therapy
critical care
ECMO
Energy intake
Extracorporeal Membrane Oxygenation
Humans
Intensive care
Intensive Care Units
Malnutrition
Malnutrition - therapy
medical nutrition therapy
Mortality
Nutrition
Oxygenation
Patients
Requirements
Retrospective Studies
Undernutrition
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Summary: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. 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. 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, = 0.007). 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.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu15092098