| Author/Editor | Majdič, Neža; Fortner, Monika; Oblak, Tina; Novak, Primož | |
| Title | Prehranska in presnovna obravnava pacientov po COVID-19 z odpovedjo dihanja | |
| Translated title | Nutritional and metabolic management of patients after COVID-19 and respiratory failure | |
| Type | članek | |
| Source | 65166083 | |
| Vol. and No. | Letnik 20, št. supl. 1 | |
| Publication year | 2021 | |
| Volume | str. 144-150 | |
| Language | slv | |
| Abstract | zhodišča: Pacienti po COVID-19 z odpovedjo dihanja, z miopatijo in/ali nevropatijo kritično bolnega imajo visoko tveganje za podhranjenost in z njo povezanimi zapleti. Namen raziskave je bil analizirati delež motenj prehranjenosti, incidenco pridruženih stanj ter sprememb laboratorijskih vrednosti, ki vplivajo na prehranski in presnovi status ter vrednosti parametrov telesne sestave. Metode: V empirično prospektivno raziskavo smo vključili 30 pacientov z miopatijo in/ali nevropatijo kritično bolnega po COVID-19 in respiratorni odpovedi, ki so bili od začetka novembra 2020 do sredine marca 2021 hospitalizirani na Oddelku za rehabilitacijo pacientov po poškodbah, s perifernimi živčnimi okvarami in revmatološkimi obolenji Univerzitetnega rehabilitacijskega inštituta Republike Slovenije - Soča (URI - Soča). Spremljali smo dejavnike telesne sestave (fazni kot, indeks nemaščobne mase, količina suhe puste mase in status hidracije) in laboratorijske vrednosti (raven vnetnih kazalcev, albumina in vitamina D ter prisotnost anemije). Postavili smo prehransko diagnozo, načrtovali prehransko zdravljenje ter paciente spremljali do zaključka rehabilitacije. Rezultati: Merila GLIM za podhranjenost je izpolnjevalo 29 od 30 pacientov, 25 od teh je bilo hudo podhranjenih (2. stopnja). Večina pacientov je v času akutnega zdravljenja izgubila 11-15 % izhodiščne telesne mase, nekateri pa tudi več kot 25 %. Pri 19 pacientih (63 %) so bila pridružena stanja, ki vplivajo na prehransko in presnovno stanje, večinoma razjede zaradi pritiska. Fazni kot je bil ob sprejemu pri vseh pacientih znižan. Med rehabilitacijo je prišlo do statistično značilnega izboljšanja, vendar so bile vrednosti še vedno pod petim populacijskim percentilom. Zaključek: Glede na rezultate raziskave lahko sklepamo, da je večina pacientov ob sprejemu na rehabilitacijo podhranjenih, zato je aktivno iskanje prehransko ogroženih ali podhranjenih pacientov nujno. S primerno prehransko in presnovno podporo lahko pripomoremo k boljšemu izidu rehabilitacije.Background: Patients after COVID-19 infection and respiratory failure with critical illness myopathy and/or neuropathy are at high nutritional risk and at high risk for malnutrition-related complications. Our aim was to determine the proportion of nutritional disorders in these patients, the frequency of associated conditions and changes in laboratory parameters that affect the nutritional and metabolic status, and to analyse values of body composition parameters. Methods: The empirical prospective study included 30 patients after COVID-19 infection and respiratory failure with critical illness myopathy and/or neuropathy, who were hospitalized in the Department for rehabilitation of patients after injuries, with peripheral nervous disorders and rheumatoid disease at the University Rehabilitation Institute in Ljubljana from the beginning of November 2020 until mid-March 2021. Body composition parameters (phase angle, fat-free mass index, dry lean mass and hydration status) and laboratory parameters (markers of inflammation, albumin, vitamin D, anaemia) were monitored. We diagnosed nutritional disorders, set the nutritional treatment plan and performed continuous monitoring. Results: Twenty-nine patients out of thirty met GLIM criteria for malnutrition, twenty-five of whom were severely malnourished (Grade 2). Most patients lost 11-15% of body mass during acute hospitalization, some even more than 25%. Nineteen patients (63%) had associated conditions that affect the nutritional and metabolic status, mostly pressure sores. All patients had low phase angle (PA) at admission. Improvement in PA during rehabilitation was statistically significant, but the values were still below the fifth percentile of population. Conclusion: The results indicate that the majority of patients are malnourished upon admission to rehabilitation, so an active screening for malnutrition is necessary. Optimal nutritional and metabolic management can contribute to a better rehabilitation outcome. | |
| Descriptors | Nutrition Therapy Rehabilitation COVID-19 | |
| Keywords | COVID-19 odpoved dihanja podhranjenost fazni kot prehranska podpora rehabilitacija COVID-19 respiratory failure malnutrition phase angle nutritional support rehabilitation |