Feeding: the hidden variable affecting prognosis of critically ill children
Abstract Background Nutrition of critically ill children is a frequently ignored issue. The purpose of this study was to describe nutritional practices in the pediatric intensive care unit (PICU) in a resource-limited country and evaluate their association with prognosis. Methods This was a prospect...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-10-01
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| Series: | Egyptian Pediatric Association Gazette |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43054-022-00136-9 |
| _version_ | 1811335116576784384 |
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| author | Muhammad Said El-Mekkawy Gamal Ibrahim Shabaan Alyaa Ahdy Abdelaziz |
| author_facet | Muhammad Said El-Mekkawy Gamal Ibrahim Shabaan Alyaa Ahdy Abdelaziz |
| author_sort | Muhammad Said El-Mekkawy |
| collection | DOAJ |
| description | Abstract Background Nutrition of critically ill children is a frequently ignored issue. The purpose of this study was to describe nutritional practices in the pediatric intensive care unit (PICU) in a resource-limited country and evaluate their association with prognosis. Methods This was a prospective observational study, conducted on critically ill children admitted into PICU. Nutritional status was assessed, and nutritional practices (enteral and parenteral) were recorded. The primary outcome was PICU mortality. Results Two hundred twenty-one patients were recruited. Mortality rate was 17.6%. Parenteral nutrition (PN) administration and longer PN duration were associated with mortality (p<0.001 for each). Early enteral nutrition was associated lower rates of mortality (5.6% vs 26.9%, p<0.001); hospital-acquired infections (18.9% vs 67.3%, p<0.001); and enteral feeding intolerance (13.3% vs 28.8%, p=0.018), compared with late enteral nutrition. Enteral nutrition onset correlated with length of PICU stay (r s =0.66, p<0.001); mechanical ventilation duration (r s =0.53, p<0.001); vasoactive infusion days (r s =0.25, p<0.001); central venous catheter days (r s =0.69, p<0.001); and time to full enteral caloric intake (r s =0.63, p<0.001). Bolus nasogastric feeding was superior to continuous nasogastric feeding since it was associated with a shorter time to full enteral caloric intake, without a higher risk of feeding intolerance or mortality. Malnutrition was associated with higher PN (75.4% vs 60.3%, p=0.03) and mortality (26.2% vs 14.1%, p=0.032) rates, in addition to longer mechanical ventilation duration (p=0.041) and time to full enteral caloric intake (p=0.010). Conclusion Malnutrition, PN, and late enteral nutrition are associated with poor outcome of PICU patients. Bolus nasogastric feeding appears to be superior to continuous feeding. |
| first_indexed | 2024-04-13T17:19:22Z |
| format | Article |
| id | doaj.art-4dc748917e8a4ed88793f3320e0fafb2 |
| institution | Directory Open Access Journal |
| issn | 2090-9942 |
| language | English |
| last_indexed | 2024-04-13T17:19:22Z |
| publishDate | 2022-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Pediatric Association Gazette |
| spelling | doaj.art-4dc748917e8a4ed88793f3320e0fafb22022-12-22T02:38:02ZengSpringerOpenEgyptian Pediatric Association Gazette2090-99422022-10-0170111010.1186/s43054-022-00136-9Feeding: the hidden variable affecting prognosis of critically ill childrenMuhammad Said El-Mekkawy0Gamal Ibrahim Shabaan1Alyaa Ahdy Abdelaziz2Department of Pediatrics, Faculty of Medicine, Menoufia UniversityDepartment of Pediatrics, Faculty of Medicine, Menoufia UniversityDepartment of Pediatrics, Faculty of Medicine, Menoufia UniversityAbstract Background Nutrition of critically ill children is a frequently ignored issue. The purpose of this study was to describe nutritional practices in the pediatric intensive care unit (PICU) in a resource-limited country and evaluate their association with prognosis. Methods This was a prospective observational study, conducted on critically ill children admitted into PICU. Nutritional status was assessed, and nutritional practices (enteral and parenteral) were recorded. The primary outcome was PICU mortality. Results Two hundred twenty-one patients were recruited. Mortality rate was 17.6%. Parenteral nutrition (PN) administration and longer PN duration were associated with mortality (p<0.001 for each). Early enteral nutrition was associated lower rates of mortality (5.6% vs 26.9%, p<0.001); hospital-acquired infections (18.9% vs 67.3%, p<0.001); and enteral feeding intolerance (13.3% vs 28.8%, p=0.018), compared with late enteral nutrition. Enteral nutrition onset correlated with length of PICU stay (r s =0.66, p<0.001); mechanical ventilation duration (r s =0.53, p<0.001); vasoactive infusion days (r s =0.25, p<0.001); central venous catheter days (r s =0.69, p<0.001); and time to full enteral caloric intake (r s =0.63, p<0.001). Bolus nasogastric feeding was superior to continuous nasogastric feeding since it was associated with a shorter time to full enteral caloric intake, without a higher risk of feeding intolerance or mortality. Malnutrition was associated with higher PN (75.4% vs 60.3%, p=0.03) and mortality (26.2% vs 14.1%, p=0.032) rates, in addition to longer mechanical ventilation duration (p=0.041) and time to full enteral caloric intake (p=0.010). Conclusion Malnutrition, PN, and late enteral nutrition are associated with poor outcome of PICU patients. Bolus nasogastric feeding appears to be superior to continuous feeding.https://doi.org/10.1186/s43054-022-00136-9MalnutritionNutritionFeedingPrognosisPediatricCritically ill children |
| spellingShingle | Muhammad Said El-Mekkawy Gamal Ibrahim Shabaan Alyaa Ahdy Abdelaziz Feeding: the hidden variable affecting prognosis of critically ill children Egyptian Pediatric Association Gazette Malnutrition Nutrition Feeding Prognosis Pediatric Critically ill children |
| title | Feeding: the hidden variable affecting prognosis of critically ill children |
| title_full | Feeding: the hidden variable affecting prognosis of critically ill children |
| title_fullStr | Feeding: the hidden variable affecting prognosis of critically ill children |
| title_full_unstemmed | Feeding: the hidden variable affecting prognosis of critically ill children |
| title_short | Feeding: the hidden variable affecting prognosis of critically ill children |
| title_sort | feeding the hidden variable affecting prognosis of critically ill children |
| topic | Malnutrition Nutrition Feeding Prognosis Pediatric Critically ill children |
| url | https://doi.org/10.1186/s43054-022-00136-9 |
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