Tolerability of enteral nutrition in extracorporeal membrane oxygenation and Covid-19

Abstract

Rationale: The use of veno-venous extracorporeal membrane oxygenation (vv-ECMO) is increasing during COVID-19 pandemic. Previous studies are controversy about tolerance of enteral nutrition to providing adequate nutrition support for patients on vv-ECMO. We aimed to evaluate the tolerance and adequation of enteral nutrition (EN) therapy in vv-ECMO COVID-19 patients compared with COVID-19 patients without vv-ECMO. Methods: We conducted a retrospective review of adult patients admitted on the COVID-19’s Intensive Care Unit (ICU) between March 2020 and April 2021. The protein and energy adequation (% of goal delivered) and adequation of prescribed versus administered volume of enteral nutrition were evaluated in vv-ECMO and non vv-ECMO patients. Results: We analyzed 126 eligible patients, 29 in vv-ECMO group and 97 in non vv-ECMO group . The mean age was 63 (SD 13,12) and 40% were obese. Mean energy were 85% (IQR, 4 - 129%) in vv-ECMO patients and 81% (IQR, 1 - 149%) in non vv-ECMO patients (p 0.056) and protein 87% (IQR, 3 e 168%) in vv-ECMO and 84% (IQR, 3 e 190%) in non vv-ECMO (p = 0.04). The adequacy between prescribed versus administered volume of enteral was greater in vv-ECMO group 84% (IQR, 5 e 100) versus 79% (IQR 1 – 100), p 0.004. Conclusion: Adequate energy and protein delivery during vv-ECMO is possible and EN is safe and well-tolerated during ECMO. Prospective studies investigating optimal feeding in this patient cohort are required. Disclosure of Interest: None declared.