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Association between nutritional status and outcomes in critically-ill pediatric patients - a systematic review
Caroline A D Costa1, Cristian T Tonial1, Pedro Celiny R Garcia1
1Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS, Brazil; Postgraduate Program in Pediatrics and Children's Health, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS, Brazil.
Insights
Nutritional depletion in critically-ill children admitted to pediatric intensive care units is linked to poorer outcomes. More research is needed to understand this association fully.
Area of Science:
- Pediatric critical care medicine
- Nutritional science
- Clinical outcomes research
Background:
- Nutritional status is a critical factor in the recovery of critically-ill pediatric patients.
- Understanding the impact of nutrition on outcomes in pediatric intensive care units (PICUs) is essential for improving patient care.
Purpose of the Study:
- To systematically review existing evidence on the association between nutritional status and hospitalization outcomes in critically-ill pediatric patients.
- To examine the impact of nutritional status on length of hospital stay, need for mechanical ventilation, and mortality in PICU patients.
Main Methods:
- A systematic literature search was conducted in Lilacs, MEDLINE, and Embase databases.
- Seven relevant articles published between 1982 and 2012 were included in the review.
- Included studies assessed nutritional status upon admission and correlated it with at least one outcome; methodological quality was evaluated.
Main Results:
- Nutritional depletion in critically-ill pediatric patients was associated with adverse outcomes.
- All included studies met quality criteria, though only four met all assessed items.
- The reviewed studies varied in their nutritional assessment and classification methods.
Conclusions:
- Nutritional depletion is linked to worse outcomes in pediatric intensive care settings.
- There is a scarcity of high-quality studies, and existing research lacks methodological consistency.
- Further well-designed contemporary studies are required to clarify the relationship between pediatric nutritional status and critical care outcomes.
Objectives:
To systematically review the evidence about the impact of nutritional status in critically-ill pediatric patients on the following outcomes during hospitalization in pediatric intensive care units: length of hospital stay, need for mechanical ventilation, and mortality.
Data Source:
The search was carried out in the following databases: Lilacs (Latin American and Caribbean Health Sciences), MEDLINE (National Library of Medicine United States) and Embase (Elsevier Database). No filters were selected.
Results:
A total of seven relevant articles about the subject were included. The publication period was between 1982 and 2012. All articles assessed the nutritional status of patients on admission at pediatric intensive care units and correlated it to at least one assessed outcome. A methodological quality questionnaire created by the authors was applied, which was based on some references and the researchers' experience. All included studies met the quality criteria, but only four met all the items.
Conclusion:
The studies included in this review suggest that nutritional depletion is associated with worse outcomes in pediatric intensive care units. However, studies are scarce and those existing show no methodological homogeneity, especially regarding nutritional status assessment and classification methods. Contemporary and well-designed studies are needed in order to properly assess the association between children's nutritional status and its impact on outcomes of these patients.