PhD defence P.L.M. (Patty) Lakenman

Below is a brief summary of the dissertation: 

This thesis investigates nutritional status of critically ill patients with COVID-19 during and after Intensive Care Unit (ICU) stay. For this purpose, a structured nutritional assessment with 4 different components was used: 1) nutrient balance (nutritional intake versus nutritional requirements taking into account nutritional losses), 2) body composition, 3) functional status, and 4) biochemical status. 
Chapter 2 describes measured energy expenditure with indirect calorimetry, feeding practices and nitrogen loss during ICU admission. The majority were found to have higher measured energy expenditure than estimated with high nitrogen losses, which may indicate a prolonged catabolic phase.
Chapter 3 evaluates the usefulness of a new calorimeter and compares measured and estimated energy needs. Although the calorimeter could be used in less than half of the patients, it proved valuable for personalising nutritional therapy.
Chapter 4 examines the relationship between gastrointestinal (GI) symptoms and nutritional intake during the first 2 weeks after ICU admission. Occurrence of GI symptoms was limited and no major barrier for adequate enteral nutrition. 
Chapter 5 analysed the relationship between measured body composition using Bio-Impedance Analysis (BIA) and clinical outcomes. Significant muscle loss was observed, but no relationship with survival. 
Chapter 6 describes nutritional status of patients 1 year post-ICU stay Although nutritional complaints were limited, nutritional status remained affected by overweight and high fat mass index. 
Conclusion The use of indirect calorimetry and BIA are valuable for personalised nutritional assessment and nutritional therapy in critically ill patients with COVID-19. Future research is needed to develop optimal nutrition strategies.