frontline (2)

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ICU Nutritional Management – Insights from the frontline

By Dr Timothy Eden, RD with contributions from Shane McAuliffe, RD and edited by Professor Sumantra Ray, RNutr

 Insights from the frontline as NNEdPro Global Innovation Panel (GIP) member Dr Tim Eden RD shares his own experience of the challenges faced in the nutritional management of COVID-19 patients in ICU: https://twitter.com/TimothyEdenRD/status/1245634083012505602 

With a high rate of COVID-19 patients in the overweight/obese category as well as those with Type-2 Diabetes, this can present a significant challenge when estimating and fulfilling these individualised nutritional requirements. Looking specifically at obese patients, there has historically been an attitude of underfeeding in intensive care, but this cohort is equally at risk of becoming malnourished (rapid, significant and unplanned weight loss) when nutritional requirements are not met for prolonged periods, and this can be a predictor of poorer clinical course and outcomes (1). The following narrative is not intended to replace clinical guidelines but is designed to highlight some key aspects relevant to nutritional assessment in ICU when treating patients with COVID-19.

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Sustaining Our Key Workers

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By James Bradfield, Dr Luke Buckner Shane McAuliffe, Dr Minha Rajput-Ray and Prof Sumantra Ray

With Acknowledgements to Dr Dominic Crocombe, Prof Martin Kohlmeier and Lord Richard Balfe

The United Kingdom is soon coming up to a month in lock-down to try and slow the rate of spread of COVID-19. Whilst majority of the public adapt to the enforced social distancing and isolation measures, designated key workers continue working in uncharted environments, often being required to work longer hours and busier shifts. Key workers include those employed in educational services, food and essential goods production, distribution and sales, logistics, utilities, communications, provision of infrastructure and financial services, public safety and security staff, local and national government as well as those facing COVID-19 head on in health and social care services.

Whilst it is vital at home people utilise this opportunity to keep themselves physically and mentally healthy given the imminent risk of infection, it is pertinent to support our key workers in staying healthy during this time.

This is being done in a variety of forms – with displays of appreciation through weekly applause, signs in windows or on buses, whilst many companies provide discounts or freebies. It is important that key workers are given these privileges, yet also essential for them to maintain their health and overall functionality.

At the NNEdPro Global Centre for Nutrition and Health, a collaborative think tank headquartered in Cambridge, a number of core members, and indeed some of the contributors to this article, are frontline healthcare workers, including Doctors, Nurses and Dietitians. Key workers often find that they do not have time to ‘eat well’ amidst a crisis such as this, which is understandable as many frontline staff are being asked to cover more frequent and longer shifts than before. This often results in erratic eating patterns, increased snacking on foods higher in calories, sugar and salt or generally not having time to prepare proper meals or indeed being over reliant on catering services are running on the bare necessities.

We believe that the points in this article will be beneficial in keeping Key Workers in as best a health state as possible. 

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