Experts on Tuesday discussed the importance of nutritional care for the critically ill COVID-19 patients.
The Department of Clinical Nutrition, a unit of Madras Medical Mission (MMM), along with the Chennai chapter of NetProFan, organised the 12th annual nutrition meet — Nutriutsav 2020 — on ‘Nutrition care process for the critically ill COVID-19 patients-A multi-disciplinary approach’.
Speaking on nutritional challenges and management of the critically ill COVID-19 patients, B. Ravinder Reddy, gastrointestinal surgeon, CARE Hospital, Hyderabad, said, “While the majority have mild disease, 5% to 10% need intensive care unit admission. The manifestations included cytokine storm, acute respiratory distress syndrome, tissue hypoxia, systemic inflammation, liver and renal dysfunction, reduced organ perfusion and gastrointestinal dysfunction.”
Risk factors
The risk factors for intensive care unit admission were people tending to be older (aged above 60), co-morbidities in 25%-40 % of patients, overweight or obesity, having initial symptoms for at least 10 days and sustained nutritional deficits prior to admission, he said.
“ICU patients required 15-20 kcal/kg/day in the initial phases,” he said, adding that the lack of feeding could pose problems of severe malnutrition, barrier dysfunction and microbial translocation, while early enteral feeds had benefits, including increasing the blood flow. He outlined the role of micro-nutrients, while noting that diarrhoea, distention, aspiration, circulatory shock, prone position, reduced absorption and regurgitation were the challenges in feeding.
Speaking on ‘Pathophysiology of malnutrition in COVID-19 Chronic Kidney Disease’, Georgi Abraham, director, nephrology, MMM, said the objective of nutrition in Chronic Kidney Disease was to prevent malnutrition, reduce uremic symptoms and slow down the progression of the disease.
Tilakavati Karupaiah, professor, School of Biosciences Faculty of Health and Medical Sciences, Malaysia, said the pandemic had impacted dietitian’s way of practice. Meenakshi Bajaj, dietitian, Tamil Nadu Government Multi Super Speciality Hospital, said nutrition was a powerful clinical and therapeutic tool in the prevention and management of non-communicable diseases and key to heart health.