Dataset Information

Impacto clinico de cumplimentar un protocolo de tratamiento nutricional en pacientes criticos afectados por SARS-CoV-2 The clinical impact of implementation of a nutritional treatment protocol in critically ill adults with SARS-CoV-2 infection

ABSTRACT:

Introducción

El paciente crítico afectado por SARS-CoV-2 tiene riesgo de desnutrición. La necesidad de evitar la sobrecarga de volumen y las maniobras que retrasan el logro de los requerimientos nutricionales como la pronación hacen que el abordaje nutricional de estos sujetos sea complejo. Para asegurar un tratamiento adecuado, se desarrolló un protocolo de soporte nutricional como guía de práctica clínica adaptado al paciente con COVID-19.

Objetivo

Describir el protocolo de soporte nutricional creado en nuestro centro, el cumplimiento del mismo y analizar los resultados de su aplicación en los pacientes con SARS-CoV-2, ingresados en la unidad de cuidados intensivos (UCI) del Consorcio Hospital General Universitario de Valencia (CHGUV) de marzo a mayo del 2020.

Material y métodos

Diseño observacional, descriptivo, retrospectivo y longitudinal para evaluar el cumplimiento de un protocolo de soporte nutricional.

Resultados

Se incluyeron 31 pacientes. No se pudo establecer un seguimiento nutricional en ocho de ellos. De los 23 restantes, ocho alcanzaron 80% de los requerimientos calóricos antes del décimo día tras el inicio del tratamiento (grupo buen cumplimiento) y 15 a partir del undécimo día (grupo mal cumplimiento). El grupo con buen cumplimiento obtuvo 75% (n = 6) de curación y 25% de éxitus (n = 2), en comparación con el grupo con «mal cumplimiento» donde 53% (n = 8) fueron dados de alta a planta vs. 47% (n = 7) que fallecieron (prueba X2, valor p = 0,019). Aquellos pacientes que alcanzaron 80% de las necesidades calóricas en algún momento del ingreso en UCI tuvieron menor duración de la hospitalización frente a los que no lo obtuvieron (mediana de días de ingreso = 14, rango intercuartílico [IQR] = 10-16 y mediana de días de ingreso = 22, IQR = 13-39, valor p = 0,025).

Conclusiones

La creación de un protocolo nutricional durante las primeras semanas de la pandemia por SARS-CoV-2 podría estar asociada con una mejoría de los resultados clínicos al favorecer la curación y disminuir las complicaciones asociadas.

SUBMITTER:

PROVIDER: S-EPMC10208262 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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