O057 - VA-ECMO AFTER CARDIAC SURGERY – INCREASED RISK FOR WORSENED NUTRITIONAL ADEQUACY COMPARED TO PATIENTS WITH NO NEED OF SPECIFIC TREATMENT?

O057

VA-ECMO AFTER CARDIAC SURGERY – INCREASED RISK FOR WORSENED NUTRITIONAL ADEQUACY COMPARED TO PATIENTS WITH NO NEED OF SPECIFIC TREATMENT?

J. Haußecker¹, C. Stoppe¹, P. Meybohm¹, D. K. Heyland², E. Dresen^1,*

¹Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany, ²Department of Critical Care Medicine, Queen's University, Kingston, Canada

Rationale: In general, cardiac surgery patients are at high risk of disease- and treatment-related iatrogenic malnutrition. However, this fact further might be worsened by need of venoarterial extracorporeal membrane oxygenation (VA-ECMO), but data investigating this are limited.

Methods: This secondary analysis of an international prospective multicenter observational study compared nutrition practices in postcardiac surgery patients receiving VA-ECMO vs. non-VA-ECMO controls (coarsened exact matching: age, sex, body mass index, Acute Physiology and Chronic Health Evaluation II score, vasopressor use). Daily nutrition data were recorded for up to 12 intensive care unit days. Energy and protein adequacy were calculated as the ratio of delivered to prescribed intake.

Results: A total of 46 patients (23 VA-ECMO and 23 controls) were included. Energy targets and actual intake in patients receiving VA-ECMO vs. controls were 24.6±5.5 kcal/kg BW/day vs. 24.5±4.8 kcal/kg BW/day (P=0.84) and 8.0±4.3 kcal/kg BW/day vs. 10.5±4.7 kcal/kg BW/day (P=0.10) (energy adequacy: 33.6% vs. 43.8%, P=0.11). Protein targets and actual intake were 1.3±0.4 g/kg BW/day vs. 1.4±0.4 g/kg BW/day (P=0.37) and 0.4±0.3 g/kg BW/day vs. 0.5±0.3 g/kg BW/day (P=0.04) in patients receiving VA-ECMO vs. controls (protein adequacy: 27.2% vs. 39.4%, P=0.05). 8.7% vs. 30.4% of VA-ECMO patients vs. controls achieved >80% of both targets by day 7 (P=0.14).

Conclusion: Energy and protein supply did not cover pre-defined targets in both groups, while VA-ECMO patients are at increased risk for undernutrition, particularly with respect to protein. Structured strategies to optimize nutrition delivery are required in the high-risk population of cardiac surgery patients in general and in specific sub-populations such as patients receiving VA-ECMO.

Disclosure of Interest: None declared