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[Transpyloric enteral nutrition in critically-ill children (II): complications]
C Sánchez Sánchez1, J López-Herce Cid, A Carrillo Alvarez
1Sección de Cuidados Intensivos Pediátricos. Hospital General Universitario Gregorio Maranon. Madrid. Spain.
Objective:
To study tolerance to transpyloric enteral nutrition (TEN) and the incidence of secondary complications in critically-ill children.
Patients And Methods:
We performed a prospective, observational study between 1994 and 2002 of all critically-ill children admitted to our pediatric intensive care unit who received TEN. Tolerance and complications were analyzed.
Results:
Of 286 patients aged between 3 days and 17 years who received TEN, gastrointestinal complications occurred in 13.6 %, abdominal distention and/or excessive gastric residue in 8 % and diarrhea in 6.3 %. Diarrhea was associated with shock (p 0.01), abdominal distension and/ or excessive gastric residue (p 0.008), hypophosphatemia (p 0.001), and duration of TEN (p < 0.001). TEN was discontinued in 2.1 % of the patients because of gastrointestinal complications. Thirty-two patients (11.2 %) died during TEN. No relationship was found between the characteristics of nutrition and complications and mortality.
Conclusions:
TEN is a well tolerated method of nutrition in critically-ill children that produces few complications.
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