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Early transpyloric enteral nutrition in critically ill children

César Sánchez1, Jesús López-Herce, Angel Carrillo

  • 1Paediatric Intensive Care Unit, Gregorio Marañón General University Hospital, Madrid, Spain.

Nutrition (Burbank, Los Angeles County, Calif.)
|December 26, 2006
PubMed

Insights

Early transpyloric enteral nutrition is well tolerated in critically ill children. Starting nutrition within 24 hours of pediatric intensive care unit admission did not increase complications compared to later initiation.

Area of Science:

  • Pediatric critical care medicine
  • Clinical nutrition
  • Gastroenterology

Background:

  • Enteral nutrition is crucial for critically ill children.
  • The optimal timing for initiating transpyloric enteral nutrition remains debated.
  • Early nutrition may prevent complications associated with prolonged fasting.

Purpose of the Study:

  • To compare the tolerance and complications of early versus late transpyloric enteral nutrition in critically ill children.
  • To evaluate the safety of initiating nutrition within 24 hours of pediatric intensive care unit admission.

Main Methods:

  • Prospective observational study of 526 critically ill children receiving transpyloric enteral nutrition.
  • Comparison of clinical characteristics, energy intake, tolerance, and complications between early (within 24h) and late (>24h) nutrition groups.
  • Data collected on diagnoses, organ dysfunction, vasoactive drug use, mortality, abdominal distention, and diarrhea.

Main Results:

  • 38.5% of children received early transpyloric nutrition (within 24h).
  • No significant differences in diagnoses, organ disturbances, vasoactive drug doses, mortality, maximum calorie delivery, or nutrition duration between groups.
  • Lower incidence of abdominal distention in the early nutrition group (3.5% vs 7.8%; P < 0.05).
  • Diarrhea incidence was similar (6.3%) in both groups.

Conclusions:

  • Early transpyloric enteral nutrition is well-tolerated in critically ill children.
  • Initiating nutrition within 24 hours of PICU admission is not associated with increased complications.
  • Early nutrition may be a safe and effective strategy for critically ill pediatric patients.
Abstract

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