Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit
1,Division of Pediatric Critical Care Medicine Mayo Clinic
DOI: 10.22514/SV102.122015.8 Vol.10,Issue 2,December 2015 pp.131-148
Published: 14 December 2015
Objective. To analyze the effects of enteral nutrition on outcomes and complications of critically ill children in the pediatric in-tensive care unit (PICU).
Design. Retrospective cohort study. Setting. PICU in a tertiary care academic medical center.
Patients. Patients up to age 17 years who were admitted to the PICU between Janu-ary 1, 2011, and December 31, 2013. Interventions. Intubation for more than 48 hours and requiring any sedative medica-tions. Patients with surgical contraindica-tions to feeding were excluded. Measures and Main Results. A total of 165 patients met inclusion criteria. Both manual review of the electronic health re-cord and automated data capture (when-ever technically feasible) were conducted. Data were collected in REDCap software and analyzed using a statistical discovery program. The mean (SD) calorie intake within the first 10 days of PICU admission was 40% (31.9%) of the prescribed calo-ries. Only 67% of the patients had feeding initiated within 48 hours of admission. No significant difference in hospital or PICU length of stay or ventilator-free days was observed in patients who met one-third of their nutritional goals (50.3%) compared with patients who did not (49.7%). Mor-tality was nonsignificantly higher among patients who did not meet nutritional goals (P=.07). No association was found between higher doses of opioids or benzo-diazepines and nutrition tolerance or gas-trointestinal complications. Conclusions. Early adequate enteral nutri-tion had no statistically significant impact on the short-term clinical outcomes of PICU patients.
critical illness, deep sedation, energy intake, pediatric intensive care unit, pediatrics, respiration, artificial
SANDEEP TRIPATHI,HARSHEEN KAUR,JITHINRAJ EDAKKANAMBETH VARAYIL,RYAN T HURT. Effects of enteral nutrition on clinical outcomes among mechanically ventilated and sedated patients in the pediatric intensive care unit. Signa Vitae. 2015. 10(2);131-148.
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