Oferta energética e proteica para pacientes críticos submetidos à oxigenação por membrana extracorpórea venovenosa (ECMO-VV): revisão sistemática

Objective: Identify the energy and protein supply for critical patients with severe respiratory failure and/or acute respiratory distress syndrome (ARDS) undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO). Methods: Systematic review with search performed on the Cochrane, Embase and MEDLINE via PubMed databases. Observational studies (cross-sectional, cohort and case-control) were included, targeting adult patients with severe respiratory failure and/or ARDS, undergoing VV-ECMO. Results: Among the 11 articles analyzed, the energy supply, when estimated using weight-based equations, ranged from 20 to 30 kcal/kg/day. When measured by indirect calorimetry, ranged from 1703 to 2013 kcal/day and from 13 to 18 kcal/kg/day. The protein supply, when estimated using weight-based equations, ranged from 1.2 to 2.5 g/kg/day; when measured by nitrogen balance, ranged from 1.8 to 2.5 g/kg/day. Conclusion: Studies to date show a great variability in the caloric-protein supply for critically ill patients in ECMO-VV. Given the importance of nutritional support, it is evident the need for further studies with better methodological design to determine the most adequate energy and protein supply for these patients.