Relationship between critical care nutrition and post-intensive care syndrome in surviving ventilated patients with COVID-19: a multicenter prospective observational study

Kensuke Nakamura, Junji Hatakeyama, Keibun Liu, Kazuma Yamakawa, Takeshi Nishida, Shinichiro Ohshimo, Shigeaki Inoue, Satoru Hashimoto, Shuhei Maruyama, Daisuke Kawakami, Yoshitaka Ogata, Katsura Hayakawa, Hiroaki Shimizu, Taku Oshima, Tatsuya Fuchigami, Osamu Nishida

Research output: Contribution to journalArticlepeer-review

Abstract

The impact of nutrition therapy in the acute phase on postintensive care syndrome (PICS) remains unclear. We conducted a multicenter prospective study on adult patients with COVID-19 who required mechanical ventilation for more than three days. The questionnaire was mailed after discharge. Physical PICS, defined as less than 90 points on the Barthel index (BI), was assigned as the primary outcome. We examined the types of nutrition therapy in the first week that affected PICS components. 269 eligible patients were evaluated 10 months after discharge. Supplemental parenteral nutrition (SPN) >400 kcal/day correlated with a lower occurrence of physical PICS (10% vs 21.92%, p = 0.042), whereas the amounts of energy and protein provided, early enteral nutrition, and a gradual increase in nutrition delivery did not, and none correlated with cognitive or mental PICS. A multivariable regression analysis revealed that SPN had an independent impact on physical PICS (odds ratio 0.33, 95% CI 0.12-0.92, p = 0.034), even after adjustments for age, sex, body mass index and severity. Protein provision ≥1.2 g/kg/day was associated with a lower occurrence of physical PICS (odds ratio 0.42, 95% CI 0.16-1.08, p = 0.071). In conclusion, SPN in the acute phase had a positive impact on physical PICS for ventilated patients with COVID-19.

Original languageEnglish
Pages (from-to)74-81
Number of pages8
JournalJournal of Clinical Biochemistry and Nutrition
Volume74
Issue number1
DOIs
Publication statusPublished - 2024

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Clinical Biochemistry

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