Diversified nutritional support of patients in severe forms of COVID-19
- 作者: Petrova M.1,2, Shestopalov A.1, Ilina A.1,2, Kutsenko A.2,3, Makarova V.3, Kuzmina I.3
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隶属关系:
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
- Peoples’ Friendship University of Russia
- Central Clinical Hospital of the Russian Academy of Sciences
- 期: 卷 2, 编号 4 (2021)
- 页面: 192-201
- 栏目: Reviews
- URL: https://journals.rcsi.science/2658-4433/article/view/101434
- DOI: https://doi.org/10.17816/clinutr101434
- ID: 101434
如何引用文章
全文:
详细
The Coronavirus Disease 2019 (COVID-19) pandemic, declared by the World Health Organization on March 11, 2020, has made significant adjustments to the principles of organizing medical care, including treatment, nutrition, and care of patients in infectious hospitals. The disease has different clinical courses: from mild asymptomatic to extremely severe, requiring aggressive medical interventions, such as organ replacement therapy to replace vital body functions.
The spread of viral infection was global, but the pathophysiological aspects of the course of COVID-19 have not been studied comprehensively. The development of acute respiratory distress syndrome and systemic inflammatory response syndrome as part of the severe course of the disease is accompanied by severe metabolic disorders that require close attention. It is necessary to correct the clinical manifestations of organ dysfunction under severe hypercatabolism. Considerable importance is given to the peculiarities of providing nutritional support to patients using specialized nutritional mixtures to prevent conditions that worsen the prognosis of recovery and survival of patients.
The target cells of the virus are angiotensin-converting enzyme receptors of the respiratory, nervous, urinary, and cardiovascular systems and organs of the gastrointestinal tract. Consequently, the site of the infection at different organs and systems gives rise to the phenomena of respiratory failure and several heterogeneous clinical manifestations of the disease, which can affect all ties in the pathogenesis of nutritional deficiency. Malnutrition is usually due to the mismatch between the intake and consumption of nutrients, micro- and macroelements.
The causes for the imbalance of the intake-expenditure system can be divided into three groups: reduced nutrient intake, increased consumption due to hypercatabolism or hypermetabolism, and malabsorption and increased nutritional losses due to direct and indirect damages to the gastrointestinal tract. The division is traditional because, in the case of severe forms of coronavirus infection, there is always the presence of two or more factors leading to nutritional deficiencies.
In this study, we systematized the ways in which we provide nutritional support based on the prevalent causes of protein-energy malnutrition, taking into account the patient’s individual needs and the extent of respiratory support. Several articles published by foreign colleagues and our own experience in the Department of Anesthesiology and Intensive Care for Patients with a New Coronavirus Infection COVID-19 at the Russian Academy of Sciences Central Clinical Hospital in Moscow in 2020 were analyzed.
This study discusses in detail the problems and characteristics of clinical nutrition that a practicing intensive care specialist faces when enduring all possible measures to maintain the stable homeostasis of the patient.
作者简介
Marina Petrova
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; Peoples’ Friendship University of Russia
Email: mpetrova@fnkcrr.ru
ORCID iD: 0000-0003-4272-0957
SPIN 代码: 9132-4190
MD, Dr. Sci. (Med.), Professor
俄罗斯联邦, Solnechnogorsky district, village Lytkino, 777, Moscow region, 141534; MoscowAlexandr Shestopalov
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: ashest@yandex.ru
ORCID iD: 0000-0002-5278-7058
SPIN 代码: 7531-6925
MD, Dr. Sci. (Med.), Professor
俄罗斯联邦, MoscowAnna Ilina
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology; Peoples’ Friendship University of Russia
Email: shishova-1992@mail.ru
ORCID iD: 0000-0001-6188-870X
SPIN 代码: 1200-3966
俄罗斯联邦, Solnechnogorsky district, village Lytkino, 777, Moscow region, 141534; Moscow
Arkady Kutsenko
Peoples’ Friendship University of Russia; Central Clinical Hospital of the Russian Academy of Sciences
Email: arka.kucenko@yandex.ru
ORCID iD: 0000-0002-8618-1679
SPIN 代码: 6361-1975
MD, Cand. Sci. (Med.)
俄罗斯联邦, Solnechnogorsky district, village Lytkino, 777, Moscow region, 141534; MoscowViktoriya Makarova
Central Clinical Hospital of the Russian Academy of Sciences
Email: vvvvvika@mail.ru
ORCID iD: 0000-0002-7736-1969
SPIN 代码: 2763-0376
MD, Cand. Sci. (Med.)
俄罗斯联邦, MoscowIrina Kuzmina
Central Clinical Hospital of the Russian Academy of Sciences
编辑信件的主要联系方式.
Email: ivkuzmina.ckb@mail.ru
ORCID iD: 0000-0003-0954-4592
SPIN 代码: 9330-6676
俄罗斯联邦, Moscow
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