2022, Number 1
Nutritional Support Practices in Pediatric Intensive Care Unit
Language: Spanish
References: 20
Page: 1-13
PDF size: 579.06 Kb.
ABSTRACT
Introduction: Children in critical condition are at high risk of malnutrition, both because of their pre-existing conditions and because of the nutritional practices applied during hospitalization, which can increase the risk of morbidity and mortality.Objective: Assess nutritional support practices and factors involved in the delivery of energy and protein in mechanically ventilated children.
Methods: Prospective observational study with analytical aspects, where a cohort of 40 mechanically ventilated patients (1-17 years) admitted to the pediatric intensive care unit of the National Institute of Children's Health was evaluated. Demographic and clinical data were recorded; daily caloric and protein intake and adequacy, interruptions in nutrition, time of stay, among others were counted.
Results: At the time of admission, 70% presented malnutrition, 77.5; 12.5; and 7.5% received enteral, parenteral and both kinds of nutrition, respectively. The onset of nutritional support on average was 3.5 days. 24% of the caloric requirements and 31% of the calculated proteins were reached. The main causes of interruption of enteral feeding in 39.4% of the time were fasting by intubation or extubation, 24.2% by surgery and 15% by elevated gastric residue.
Conclusions: There is a high rate of malnutrition and poor adequacy of the prescribed caloric and protein requirement. The implementation of a nutrition protocol can facilitate the nutritional management of the pediatric patient in critical condition.
REFERENCES
Roudi F, Khademi G, Ranjbar G, Pouryazdanpanah M, Pahlavani N, Boskabady A, et al. The Effects of Implementation of a Stepwise Algorithmic Protocol for Nutrition Care Process in Gastro-Intestinal Surgical Children in Pediatric Intensive Care Unit Clin Nut ESPEN. 2021;43:250-8. DOI: https://doi.org/10.1016/j.clnesp.2021.04.004.
Mehta NM, Skillman HE, Irving SY, Coss‐Bu JA, Vermilyea S, Farrington EA, et al. Guidelines for the provision and assessment of nutrition support therapy in the pediatric critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. J Parenter Enteral Nutr. 2017;41(5):706-42. DOI: https://doi.org/10.1177/0148607117711387
Bechard L, Duggan C, Touger R, Scott J, Rothpletz P, Byham L, et al. Nutritional status based on body mass index is associated with morbidity and mortality in mechanically ventilated critically ill children in the PICU. Crit Care Med. 2016;44:1530-7. DOI: https://doi.org/10.1097/CCM.0000000000001713
Galera-Martínez R, López-Ruzafa E, López AM, Moráis AL, Lama RAM. Actualización en el soporte nutricional del paciente pediátrico críticamente enfermo. Acta Pediatr Esp. 2017 [acceso 26/05/2021];75(7-8):e117-23. Disponible en: Disponible en: https://www.proquest.com/openview/767ae4ae1da1fcbd38190fa41f7a5426/1?pq-origsite=gscholar&cbl=31418
Moullet C, Schmutz E, Depeyre JL, Perez MH, Cotting J, Chaparro CJ. Physicians' perceptions about managing enteral nutrition and the implementation of tools to assist in nutritional decision-making in a paediatric intensive care unit. Aust Crit Care. 2020;33(3):219-27. DOI: https://doi.org/10.1016/j.aucc.2020.03.003