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Outcomes in a pediatric intensive care unit before and after the implementation of a nutrition support team

Gisele Limongeli Gurgueira1, Heitor Pons Leite, José Augusto de Aguiar Carrazedo Taddei

  • 1Pediatric Intensive Care Unit and the Discipline of Nutrition and Metabolism, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.

JPEN. Journal of Parenteral and Enteral Nutrition
|April 20, 2005
PubMed

Insights

Implementing a nutrition support team (NST) significantly increased enteral nutrition (EN) and decreased parenteral nutrition (PN) use in pediatric intensive care units (PICUs). This improved nutrition support strategy led to a notable reduction in PICU mortality rates.

Area of Science:

  • Pediatric critical care medicine
  • Clinical nutrition
  • Healthcare quality improvement

Background:

  • Parenteral nutrition (PN) and enteral nutrition (EN) impact outcomes in pediatric intensive care units (PICUs).
  • Continuous education programs and nutrition support teams (NSTs) can optimize nutrition delivery.
  • Evaluating the effect of these interventions on PICU mortality is crucial.

Purpose of the Study:

  • To assess the impact of a continuous education program in nutrition support on PN and EN use.
  • To evaluate the effect of implementing a nutrition support team (NST) on in-PICU mortality.
  • To analyze changes in nutrition delivery and patient outcomes over time.

Main Methods:

  • Historical cohort study of infants hospitalized in a PICU from 1992 to 2003.
  • Analysis of five periods reflecting program modifications, including NST implementation.
  • Comparison of patient characteristics, length of stay, ventilation duration, and mortality rates.
  • Bi- and multivariate statistical analyses were performed.

Main Results:

  • Enteral nutrition (EN) use progressively increased, reaching 67% in medical patients by the final period (P5).
  • Parenteral nutrition (PN) use significantly decreased to 0% by P5 for both medical and surgical patients.
  • A significant reduction in in-PICU mortality was observed during later periods (P4 and P5).
  • Patients receiving EN for >50% of their length of stay had an 83% lower risk of death.

Conclusions:

  • The nutrition support education program successfully increased EN and decreased PN utilization.
  • Implementation of a nutrition support team (NST) was associated with reduced in-PICU mortality.
  • Optimized nutrition support, particularly EN, is linked to improved survival in critically ill children.
Abstract

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