Table 2.
Characterization of feeding intolerance in critically ill patients with COVID-19.a
| Feeding intolerance (N = 180) |
|
|---|---|
| Signs & symptoms of feeding intolerance | |
| Nausea | 44 (24.4) |
| Retching | 13 (7.2) |
| Vomiting | 115 (63.9) |
| Abdominal pain | 30 (16.7) |
| Abdominal distension | 121 (67.2) |
| Diarrhea | 50 (27.8) |
| Constipation | 67 (37.2) |
| Large GRV that required holding tube feed with one or more s/s above | 137 (76.1) |
| Large GRV that required holding tube feed without s/s | 14 (7.8) |
| Largest documented GRV in ICU, mean (IQR), mLb | 473 (300–600) |
| Time course of feeding intolerance | |
| Time to development of feeding intolerance since initiation of tube feed, median (IQR), days | 4 (2–8) |
| Duration of feeding intolerance, median (IQR), days | 7 (4–12) |
| Development of subsequent feeding intolerance episode(s) | 42 (23.3) |
| Route of feeding during ICU admission | |
| OG/NG | 176 (97.8) |
| PEG tube | 52 (28.9) |
| J tube | 2 (1.1) |
| Type of GI dysmotility by imaging assessmentc | |
| Gastroparesis | 2 (1.3) |
| Ileus | 30 (19.4) |
| Colonic pseudo-obstruction (Ogilvie) | 3 (1.9) |
| Unspecified/cannot be determined | 123 (79.4) |
| Total parenteral nutrition (TPN) | |
| Initiation of TPN | 33 (18.3) |
| Duration of TPN, median (IQR), days | 8 (4–12) |
| Complications from feeding intolerance | |
| Malnutrition | 90 (50.0) |
| Documented vomiting or regurgitation while intubated | 116 (64.4) |
| Bowel perforation | 3 (1.7) |
| New bloodstream infection while on TPN | 5 (15.2) |
Abbreviations: GRV, gastric residual volume; s/s, signs and symptoms; ICU, intensive care unit; IQR, interquartile range; OG/NG, orogastric/nasogastric tube; PEG tube, percutaneous endoscopic gastrostomy tube; J tube, jejunostomy tube.
Data are shown as number (percentage) unless otherwise noted. Percentages are rounded.
There were 4 patients with missing GRV values during the ICU admission who were not included in this analysis.
Imaging assessment was determined by radiologist review of gastrointestinal imaging (abdominal x-ray and/or CT abdomen/pelvis) during feeding intolerance episodes. 25 patients did not have available abdominal imaging during feeding intolerance episodes and were not included in this analysis.