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Nutritional support in critically ill children.

R M Taylor1, V R Preedy, A J Baker

  • 1Institute of Liver Studies, King's College Hospital, Denmark Hill, London, UK.

Clinical Nutrition (Edinburgh, Scotland)
|July 26, 2003
PubMed
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Critically ill children often receive suboptimal nutrition, with significant shortfalls in energy intake despite the availability of enteral nutrition. A proactive approach is needed to optimize nutritional support in pediatric intensive care units.

Area of Science:

  • Pediatric Critical Care Medicine
  • Clinical Nutrition
  • Intensive Care Unit Management

Background:

  • Enteral nutrition is the preferred method for feeding critically ill patients.
  • Current practices indicate that a significant proportion of critically ill children do not receive adequate nutritional support.
  • This highlights a gap between recommended and actual nutritional delivery.

Purpose of the Study:

  • To retrospectively evaluate the effectiveness of nutritional support in critically ill children.
  • To identify factors influencing the delivery and adequacy of nutrition in this population.

Main Methods:

  • A retrospective review of medical records for 95 children admitted to the pediatric intensive care unit (PICU) for at least 3 days.
  • Data collection focused on the administration and delivery of enteral and parenteral nutrition.

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Main Results:

  • Only 59% of children received nutrition within 24 hours of admission.
  • Enteral nutrition was administered in 54% of cases, with 10% requiring parenteral nutrition and 9.5% receiving none.
  • Children achieved a median of 58.8% of their energy requirements, with optimization delayed until day 10.
  • Frequent interruptions of enteral nutrition (264 times) and prevalent gastrointestinal issues (constipation, diarrhea) impacted delivery.

Conclusions:

  • While enteral nutrition can be administered safely, current practices are insufficient to meet the energy needs of critically ill children.
  • A more proactive and optimized strategy for nutritional support is essential.
  • Addressing interruptions and gastrointestinal complications is crucial for improving outcomes.