Background and Importance The critical patient is by definition a patient at nutritional risk for presenting a hypermetabolic state which leads to a rapid process of malnutrition. Nutrometabolic treatment in this type of patient is a fundamental part of a better clinical evolution.

Aim and Objectives To describe how the parenteral nutrition prescription was adapted to the nutrition guidelines in patients with COVID-19 disease in critical care units (ICU).

Material and Methods Retrospective observational study of patients with total parenteral nutrition (TPN) in critical care units between March and May 2020.

Data from the Electronic Medical Record and the TPN prescription were recorded: age, sex, weight, days of admission to the ICU, TPN indication, duration of TPN therapy, co-administration of Enteral Nutrition (EN) (if applicable), total energy intake and daily prescribed protein and complications from TPN.

Energy and protein requirements were calculated based on the ASPEN ‘Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient’ and the hospital’s COVID-19 Nutrition Protocol: 11–14 Kcal/Kg/day for obese patients and 25 Kcal/Kg/day for non-obese patients. 1.5g/Kg/day of protein was calculated for all patients.

The agreement with the guidelines was accepted if the percentage of total energy and protein requirements was within 80–120%.

Results Thirteen patients with TPN were identified (table 1).

Median number of days in the critical unit was 38 days (12–73). Median number of days with TPN was 13 (2–53). Median percentage of days with TPN (compared to the total days spent in the critical care unit) was 36.8% (7.1–72.6). Median calculated energy requirements were 1,800 Kcal/day (1150–2137), and median protein requirements per day were 130.5 grams of protein (105–163.5). A total of 28 prescriptions were recorded. Median total Kcal prescribed per day was 1,827 Kcal (1035–2475), and median protein intake was 100 grams (57–147.5). 18 (64.3%) total daily Kcal prescriptions and 9 (32%) of the protein prescriptions were adapted to the guidelines.

Conclusion and Relevance We found low adaptation of the prescriptions to the guidelines in relation to grams of protein (kidney involvement could be responsible), although the total energy requirements were adapted. The high rate of catheter bacteraemia was striking.

Conflict of Interest No conflict of interest.