Patients receiving extracorporeal membrane oxygenation (ECMO) are considered nutritionally vulnerable, with previous studies focussed on Intensive Care Unit (ICU) admission alone. We aimed to address this gap by describing nutrition provision and practices during the ICU and post-ICU ward admission in adults who received ECMO.

A prospective observational study was conducted across ten tertiary hospitals within the ECMO registry (EXCEL) in Australia. Data were collected on day 1 (ECMO initiation), 3, 7 and then 7-daily to day 60. The primary outcome was energy provision (% of clinician-prescribed target). Secondary outcomes were energy delivery (kcal/day), protein delivery (g/day) and protein provision (% of clinician-prescribed target). Mixed-effects linear modelling was used to compare data in the ICU and post-ICU ward setting.

147 patients were included between June 2022 and July 2023; 91 (62%) males, mean ± standard deviation age 48 ± 16 y. The median [interquartile range] duration of ECMO was 6 d [4–12], with an ICU and hospital stay of 18 d [10–28] and 27 d [12–48] respectively. Energy delivery was 1223 ± 568 kcal/d in ICU (n = 140) and 1519 ± 765 kcal/d on the post-ICU ward in a subgroup with available data (n = 37), providing 64 ± 26% and 70 ± 34% of energy targets, respectively. Protein delivery was 60 ± 31 g/d in ICU and 72 ± 40 g/d on the post-ICU ward meeting 61 ± 29% and 77 ± 40% of protein targets, respectively. No significant differences were observed between the ICU and post-ICU ward.

Energy and protein delivery were comparable between the ICU and post-ICU ward, consistently remaining below prescribed targets. This may reflect an evidence-based shift early in ICU, but persistent deficits post-ICU may impair recovery and warrant further investigation.