María José Solana1, Gema Manrique1, Reyes Fernández2, María Slocker3, Miriam García1, Silvia Redondo4, Cristina Yun5, Raquel Gil5, Mónica Balaguer6, Eva Rodríguez7, Aranzazu González-Posada8, Carmen Santiago9, Carmen María Martín10, María Miñambres11, María Sánchez12, Concepción Goñi13, Jorge López1, Jesus López-Herce1. 1. Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 2. Pediatric Intensive Care Unit, Hospital Universitario Central de Asturias, Oviedo, Spain. 3. Pediatric Intensive Care Unit, Hospital Virgen de La Arrixaca, Murcia, Spain. 4. Pediatric Intensive Care Unit, Hospital Universitario Cruces, Vizcaya, Spain. 5. Pediatric Intensive Care Unit, Hospital Regional Universitario de Málaga, Málaga, Spain. 6. Pediatric Intensive Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Pediatric Intensive Care Unit, Hospital Sant Joan de Deu, Barcelona, Spain. 7. Pediatric Intensive Care Unit, Hospital Nuestra Señora de la Candelaria, Tenerife, Spain. 8. Pediatric Intensive Care Unit, Hospital Doce de Octubre, Madrid, Spain. 9. Pediatric Intensive Care Unit, Complejo Hospitalario de Jaén, Jaén, Spain. 10. Pediatric Intensive Care Unit, Complejo Universitario de Toledo, Toledo, Spain. 11. Pediatric Intensive Care Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. 12. Pediatric Intensive Care Unit, Hospital Ramón y Cajal, Madrid, Spain. 13. Pediatric Intensive Care Unit, Complejo universitario de Navarra, Pamplona, Spain.
Abstract
OBJECTIVES: Critically ill children are often malnourished and require nutrition support (NS). Early enteral nutrition (EEN) seems to be safe in critically ill patients. However, there is a scarcity of data about the management of EEN in sick pediatric patients. The aim of this study was to analyze the nutritional status, NS characteristics, macronutrient supply, and associations between NS and outcomes in critically ill children in Spain. METHODS: This was a multicentric, prospective, cross-sectional study involving critically ill children who received NS and with an expected length of stay (LOS) in the pediatric intensive care unit of ≥3 d. Anthropometric variables, characteristics of NS, EEN, nutrient supply, and complications were recorded. RESULTS: We enrolled 86 children. Undernutrition and overweight were more prevalent in children ≤2 y of age than in older children (undernutrition: 40 versus 19%, respectively; overweight: 22.2 versus 14.3%, respectively). Being overweight was associated with a shorter PICU LOS (5.8 ± 2 versus 9.8 ± 6.5; P = 0.005). EN was the preferred method for nutrient delivery. EEN was administered to 58.1% of patients and was more common in children >2 y of age than in younger patients (73.1 versus 44.4%; P = 0.015). EEN was safe and was associated with a higher caloric intake (81.6 ± 35.3 versus 59.6 ± 36.6; P = 0.019). There was a negative correlation between mean time to EN initiation and maximum energy supply (r = -0.32; P = 0.07). CONCLUSIONS: Malnutrition was prevalent among critically ill children in Spain. Being overweight was associated with a shorter PICU LOS. EEN was safe and was associated with a higher caloric intake; however, it is rarely used in PICUs in Spain.
OBJECTIVES:Critically illchildren are often malnourished and require nutrition support (NS). Early enteral nutrition (EEN) seems to be safe in critically illpatients. However, there is a scarcity of data about the management of EEN in sick pediatric patients. The aim of this study was to analyze the nutritional status, NS characteristics, macronutrient supply, and associations between NS and outcomes in critically illchildren in Spain. METHODS: This was a multicentric, prospective, cross-sectional study involving critically illchildren who received NS and with an expected length of stay (LOS) in the pediatric intensive care unit of ≥3 d. Anthropometric variables, characteristics of NS, EEN, nutrient supply, and complications were recorded. RESULTS: We enrolled 86 children. Undernutrition and overweight were more prevalent in children ≤2 y of age than in older children (undernutrition: 40 versus 19%, respectively; overweight: 22.2 versus 14.3%, respectively). Being overweight was associated with a shorter PICU LOS (5.8 ± 2 versus 9.8 ± 6.5; P = 0.005). EN was the preferred method for nutrient delivery. EEN was administered to 58.1% of patients and was more common in children >2 y of age than in younger patients (73.1 versus 44.4%; P = 0.015). EEN was safe and was associated with a higher caloric intake (81.6 ± 35.3 versus 59.6 ± 36.6; P = 0.019). There was a negative correlation between mean time to EN initiation and maximum energy supply (r = -0.32; P = 0.07). CONCLUSIONS: Malnutrition was prevalent among critically illchildren in Spain. Being overweight was associated with a shorter PICU LOS. EEN was safe and was associated with a higher caloric intake; however, it is rarely used in PICUs in Spain.
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