Under- and overfeeding in Intensive Care Units (ICUs) are linked to prolonged hospitalisation, increased morbidity, and elevated mortality. This study investigates whether ICU patients were optimally nourished according to the European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines. Methods: A cohort of 158 COVID-19 patients requiring intensive care for severe respiratory failure, necessitating a nuanced approach to nutritional support, was analysed. Nutritional status was determined regarding kilocalories and protein using the Energy Expenditure derived from ventilator-measured VCO2 and the adjusted Weir equation, and data on intake through enteral feeding was used. The study included ventilated patients hospitalised for over five days without Extra Corporeal Life Support (ECLS) and receiving enteral nutrition. Associations between mortality and (i) calorie intake and (ii) protein intake were examined using Chi-Square statistics. Results: Conforming to the ESPEN guidelines, 45% of patients were malnourished, and 21% were over-nourished in kilocalories. Additionally, 61% were malnourished, and 16% were over-nourished in protein. The distribution between the groups of survivors and deceased relative to each of the groups well nourished, malnourished, and over-nourished was not statistically different (p = 0.21). The protein distribution among survivors and deceased groups was not statistically different (p = 0.67) regarding correct, insufficient, or excessive protein intake. Conclusions: Based on ESPEN guidelines, most ICU patients were inadequately nourished in kilocalories and protein. However, no significant survival differences were observed across groups with varying nutritional adequacy. Further research is recommended to explore the implications of nutritional interventions in critically ill patients.
It is suggested that older patients waiting for an elective surgical procedure have a poor nutritional status and low physical activity level. It is unknown if this hypothesis is true and if these conditions improve after a medical procedure. We aimed to determine the trajectory of both conditions before and after transcatheter aortic valve implantation (TAVI). Included patients (n = 112, age 81 ± 5 years, 58% male) received three home visits (preprocedural, one and six months postprocedural). Nutritional status was determined with the mini nutritional assessment-short form (MNA-SF) and physical activity using an ankle-worn monitor (Stepwatch). The median MNA-SF score was 13 (11-14), and 27% of the patients were at risk of malnutrition before the procedure. Physical activity was 6273 ± 3007 steps/day, and 69% of the patients did not meet the physical activity guidelines (>7100 steps/day). We observed that nutritional status and physical activity did not significantly change after the procedure (β 0.02 [95% CI -0.03, 0.07] points/months on the MNA-SF and β 16 [95% CI -47, 79] steps/month, respectively). To conclude, many preprocedural TAVI patients should improve their nutritional status or activity level. Both conditions do not improve naturally after a cardiac procedure.
This project has received funding from the Bio-based Industries Joint Undertaking under the European Union's Horizon 2020 research and innovation programme under grant agreement No 720726LIBBIO is a European research project on Andes Lupin (Lupinus mutabilis, tarwi) cropping in marginal lands for enhanced bio economy. Lupin has the ability to fix nitrogen, mobilise soil phosphate and has low nutritional requirements for cultivation. Varieties will be chosen that give high yield of green silage or high yield of seeds which contain more than 20% oil, more than 40% protein and the remaining materials are carbohydrates, mainly oligosaccharides characterized as “prebiotics”. Andes lupin will be grown as a summer crop in N-central Europe and as winter crop in Mediterranean conditions. Pre-industrial processing is developed and optimized for the lupin, properties of the different fractions analysed, their advantage for different industrial use evaluated, and a few products developed as an example. Social and environmental impact will be evaluated as well as techno-economic viability and effect on farm and biorefinery income.This project has received funding from the Bio-based Industries Joint Undertaking under the European Union's Horizon 2020 research and innovation programme under grant agreement No 720726