(401) Not So Novel: Equivalent Enteral Feeding Rates in ICU COVID-19-Positive and -Negative Patients

Introduction: There are specific considerations for feeding critically-ill COVID + patients, including hemodynamic instability, gastrointestinal symptoms, and a prolonged hyper-metabolic state. For enteral nutrition (EN), a daily energy target and volume goal is determined by the Registered Dietitian (RD). The goal is either delivered by a volume-based feeding (VBF) or a rate-based feeding (RBF) regimen. Our hypothesis is that COVID + patients will receive a reduced percentage of goal enteral intake due to impaired gastric motility, hemodynamic instability, and positional challenges with EN tolerance.

Methods: This retrospective, single-center quality improvement study included adult patients in the intensive care units between March 2020 and April 2023. A demographic data point was COVID-19 status. Patients from group facilities (LTACH, SNF), were dependent on EN prior to admission, received any parenteral nutrition, or had recent transplants were excluded. Primary outcome was whether a patient received RBF vs. VBF vs. mixed and percentage of goal enteral intake achieved. Fisher’s Exact Test was used for categorical comparisons, and the Bonferroni correction was used to account for multiple comparisons.

Results: One hundred patients were included; 78 tested negative for COVID, 16 tested positive, and 6 were not tested. Patients who were COVID – received 66.44% of their goal enteral intake and COVID + received 64.81% (p = 0.765). In the mixed enteral feeding group, 50% (7) of the patients were COVID +. For COVID + patients, there was a statistically significant difference comparing those who received mixed vs. RBF but no significance in mixed vs. VBF (adjusted p = 0.006, 0.123 respectively).

Conclusions: COVID + patients were fed an equivalent amount of their caloric intake goal compared to COVID – counter parts. Additionally, COVID + patients were more likely to receive a mixed EN regimen. As determined by the RD, patients would receive RBF, VBF, or mixed EN regimen based on hemodynamic stability, malnutrition status, electrolyte abnormalities, patient positioning, and gastrointestinal tolerance. Further research with a larger sample size and investigation into nutrition and nursing protocols during COVID-19 may provide further insight.