Kristin C Greathouse1, Kelly T Sakellaris1, Dmitry Tumin1,2, Jacob Katsnelson3, Joseph D Tobias1,2,3, Don Hayes1,3,4, Andrew R Yates1,3,5,6. 1. Nationwide Children's Hospital, Columbus, Ohio, USA. 2. Department of Anesthesia, Nationwide Children's Hospital, Columbus, Ohio, USA. 3. Ohio State University, Columbus, Ohio, USA. 4. Department of Pulmonology, Nationwide Children's Hospital, Columbus, Ohio, USA. 5. Department of Cardiology, Nationwide Children's Hospital, Columbus, Ohio, USA. 6. Department of Critical Care, Nationwide Children's Hospital, Columbus, Ohio, USA.
Abstract
INTRODUCTION: Pediatric data related to safety, tolerance, and outcomes of enteral nutrition (EN) for patients requiring extracorporeal membrane oxygenation (ECMO) are lacking. The objectives of this study were to evaluate early nutrition status and timing of EN initiation on survival during pediatric ECMO. METHODS: A single center institutional review board-approved retrospective chart review was performed on all pediatric patients requiring ECMO from October 2008 through December 2013. Demographics, ECMO variables, laboratory values, vasoactive inotropic score (VIS), and nutrition data on day 5 (d5) were collected. Patients receiving parenteral nutrition (PN) were compared with those receiving any EN on d5. Analyses were conducted to identify factors influencing survival to completion of ECMO and to discharge. RESULTS: Forty-nine patients aged 53 ± 76 months met inclusion criteria. Kaplan-Meier curves demonstrated greater survival to discharge in patients receiving any EN, compared with only receiving PN (P = .031). EN on d5 of ECMO support (P = .040) and a higher percentage of daily energy intake achieved (P = .013) were protective, whereas a higher VIS was associated with increased mortality (P = .010). Multivariable analysis demonstrated EN was no longer associated with survival to discharge (P = .139), whereas energy intake (P = .021) and VIS (P = .013) remained significant. CONCLUSIONS: Pediatric patients who received nutrition that was closer to goal energy intake, as well as those who received any EN early during ECMO, had improved survival to hospital discharge.
INTRODUCTION: Pediatric data related to safety, tolerance, and outcomes of enteral nutrition (EN) for patients requiring extracorporeal membrane oxygenation (ECMO) are lacking. The objectives of this study were to evaluate early nutrition status and timing of EN initiation on survival during pediatric ECMO. METHODS: A single center institutional review board-approved retrospective chart review was performed on all pediatric patients requiring ECMO from October 2008 through December 2013. Demographics, ECMO variables, laboratory values, vasoactive inotropic score (VIS), and nutrition data on day 5 (d5) were collected. Patients receiving parenteral nutrition (PN) were compared with those receiving any EN on d5. Analyses were conducted to identify factors influencing survival to completion of ECMO and to discharge. RESULTS: Forty-nine patients aged 53 ± 76 months met inclusion criteria. Kaplan-Meier curves demonstrated greater survival to discharge in patients receiving any EN, compared with only receiving PN (P = .031). EN on d5 of ECMO support (P = .040) and a higher percentage of daily energy intake achieved (P = .013) were protective, whereas a higher VIS was associated with increased mortality (P = .010). Multivariable analysis demonstrated EN was no longer associated with survival to discharge (P = .139), whereas energy intake (P = .021) and VIS (P = .013) remained significant. CONCLUSIONS: Pediatric patients who received nutrition that was closer to goal energy intake, as well as those who received any EN early during ECMO, had improved survival to hospital discharge.
Authors: Vijay Srinivasan; Natalie R Hasbani; Nilesh M Mehta; Sharon Y Irving; Sarah B Kandil; H Christine Allen; Katri V Typpo; Natalie Z Cvijanovich; E Vincent S Faustino; David Wypij; Michael S D Agus; Vinay M Nadkarni Journal: Pediatr Crit Care Med Date: 2020-03 Impact factor: 3.624
Authors: Gema Pérez; Elena González; Laura Zamora; Sarah N Fernández; Amelia Sánchez; Jose María Bellón; María José Santiago; María José Solana Journal: J Pediatr Gastroenterol Nutr Date: 2022-01-01 Impact factor: 3.288