Case report: Nutrition therapy and side-effects monitoring in critically ill coronavirus disease 2019 patients.
Hanxiao Chen, Yu Xue, Yu He and 4 others
PMID 33248420WHAT IT FOUND
In critically ill older adults with severe malnutrition, tube feeding was limited by gastric retention, diarrhea, and hypoglycemia.
In the reported cases, jejunal feeding plus parenteral support improved tolerance, while the other patient remained nutritionally inadequate.
Key findings
01The patients had severe malnutrition and frequent gastric retention and diarrhea.
02Case 1 had improved gastrointestinal tolerance and bowel movements after nasojejunal trophic feeding plus parenteral nutrition, and parenteral nutrition was stopped when enteral nutrition could ensure sufficient supply.
03Case 2 remained nutritionally inadequate because parenteral nutrition was limited and attempts to place a nasojejunal tube were associated with decreased heart rate and unstable vital signs.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only two patients are described, so this cannot show what will work for most critically ill patients. The patients received several changes at once, including probiotics, formula changes, feeding rate changes, tube site changes, and parenteral nutrition, so the contribution of any single component cannot be separated. Body weight and metabolic rate could not be measured in the isolation wards, so energy needs were estimated from alternative assessment and clinical experience. The second patient remained nutritionally inadequate, and the authors report failed attempts to place a nasojejunal tube and limited parenteral nutrition support. This is a case report, not a controlled trial, so it cannot establish efficacy or compare treatments.
Declared interests
Funding came from Sichuan Provincial Finance Department and Science & Technology Department of Sichuan Province (grant number 2020YFS0005), National Natural Science Foundation of China (grant number 82070660), and Department of Science and Technology of Sichuan Province (grant number 20QYCX0100). The authors declared no conflict of interest.
The easy way to misread this
Do not read this as evidence that probiotics, gastric to jejunal tube changes, parenteral nutrition, or formula changes improve outcomes. These were given together in the reported patients, so the contribution of any single component cannot be separated.