Evidence map›Paper›PMID 33934924›Full record

ArticleClinical nutrition (Edinburgh, Scotland)2022

Feeding intolerance in critically ill patients with COVID-19.

Rebecca Liu, Mary Paz, Layla Siraj, Taylor Boyd, Silvia Salamone, Thúy-Lan Võ Lite, Krystle M Leung, Josue D Chirinos, Helen H Shang, Matthew J Townsend and 13 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical nutrition (Edinburgh, Scotland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
7.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 2 institutions in 1 country.

Rebecca LiuDepartment of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Mary PazDivision of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Layla SirajHarvard Medical School, Boston, MA 02115, USA; Program in Health Sciences & Technology, Harvard Medical School & Massachusetts Institute of Technology, Boston, MA 02115, USA.
Taylor BoydHarvard Medical School, Boston, MA 02115, USA.
Silvia SalamoneHarvard Medical School, Boston, MA 02115, USA.
Thúy-Lan Võ LiteHarvard Medical School, Boston, MA 02115, USA.
Krystle M LeungDepartment of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Josue D ChirinosHarvard Medical School, Boston, MA 02115, USA.
Helen H ShangHarvard Medical School, Boston, MA 02115, USA.
Matthew J TownsendHarvard Medical School, Boston, MA 02115, USA.
Junsung RhoDivision of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Peiyun NiDepartment of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Kushi RanganathHarvard Medical School, Boston, MA 02115, USA.
April D ViolanteDivision of Clinical Nutrition, Department of Nutrition and Food Services, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Zezhou ZhaoHarvard Medical School, Boston, MA 02115, USA; Program in Health Sciences & Technology, Harvard Medical School & Massachusetts Institute of Technology, Boston, MA 02115, USA.
Casey SilvernaleDivision of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Imama AhmadDepartment of Medicine, North Shore Medical Center, Salem, MA 01970, USA.
Nira A KrasnowHarvard Medical School, Boston, MA 02115, USA.
Erica S BarnettHarvard Medical School, Boston, MA 02115, USA.
Mukesh HarisinghaniDivision of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Braden KuoDivision of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Katharine E BlackDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Kyle StallerDivision of Gastroenterology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. Electronic address: kstaller@mgh.harvard.edu.
Harvard University · USNorth Shore Medical Center · US

Funding

Medical Scientist Training ProgramT32GM007753 · NIGMS · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI WALENSKY, LOREN DAVID · 1985 to 2021
$50.0M
MOLECULAR BIOPHYSICS TRAINING GRANTT32GM008313 · NIGMS · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI MURTHY, VENKATESH N · 1989 to 2023
$14.6M
The Role of Fiber in the Etiopathogenesis of Fecal IncontinenceK23DK120945 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI STALLER, KYLE · 2020 to 2024
$1.0M
NIDDK NIH HHS K23 DK120945NIGMS NIH HHS T32 GM007753NIGMS NIH HHS T32 GM008313
6 · The paper itself

Abstract

BACKGROUND &

aimsEarly reports suggest significant difficulty with enteral feeding in critically ill COVID-19 patients. This study aimed to characterize the prevalence, clinical manifestations, and outcomes of feeding intolerance in critically ill patients with COVID-19.

methodsWe examined 323 adult patients with COVID-19 admitted to the intensive care units (ICUs) of Massachusetts General Hospital between March 11 and June 28, 2020 who received enteral nutrition. Systematic chart review determined prevalence, clinical characteristics, and hospital outcomes (ICU complications, length of stay, and mortality) of feeding intolerance.

resultsFeeding intolerance developed in 56% of the patients and most commonly manifested as large gastric residual volumes (83.9%), abdominal distension (67.2%), and vomiting (63.9%). Length of intubation (OR 1.05, 95% CI 1.03-1.08), ≥1 GI symptom on presentation (OR 0.76, 95% CI 0.59-0.97), and severe obesity (OR 0.29, 95% CI 0.13-0.66) were independently associated with development of feeding intolerance. Compared to feed-tolerant patients, patients with incident feeding intolerance were significantly more likely to suffer cardiac, renal, hepatic, and hematologic complications during their hospitalization. Feeding intolerance was similarly associated with poor outcomes including longer ICU stay (median [IQR] 21.5 [14-30] vs. 15 [9-22] days, P < 0.001), overall hospitalization time (median [IQR] 30.5 [19-42] vs. 24 [15-35], P < 0.001) and in-hospital mortality (33.9% vs. 16.1%, P < 0.001). Feeding intolerance was independently associated with an increased risk of death (HR 3.32; 95% CI 1.97-5.6).

conclusionsFeeding intolerance is a frequently encountered complication in critically ill COVID-19 patients in a large tertiary care experience and is associated with poor outcomes.

Indexed as

COVID-19Critical IllnessAdultEnteral NutritionHospital MortalityHumansInfant, NewbornIntensive Care UnitsFeeding intoleranceGI dysmotilityICUMalnutritionSARS-CoV-2

Identifiers

PMID33934924
PMCPMC8007186
OpenAlexW3145235885

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.