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Nutritional status as a predictor of duration of mechanical ventilation in critically ill children

Rafaela B Grippa1, Paola S Silva2, Eliana Barbosa3

  • 1Postgraduate Program in Nutrition, Federal University of Santa Catarina, Florianópolis, Brazil.

Nutrition (Burbank, Los Angeles County, Calif.)
|July 2, 2016
PubMed

Insights

Malnutrition in critically ill children admitted to the pediatric intensive care unit (PICU) is linked to longer mechanical ventilation durations. Early nutritional assessment on admission can guide targeted interventions for better outcomes.

Area of Science:

  • Pediatric Intensive Care
  • Nutritional Science
  • Critical Care Medicine

Background:

  • Critically ill children in the pediatric intensive care unit (PICU) frequently experience malnutrition.
  • Nutritional status on admission is a crucial factor influencing patient recovery and treatment duration.

Purpose of the Study:

  • To investigate the predictive role of nutritional status upon admission for the duration of mechanical ventilation in critically ill children.
  • To establish the association between malnutrition and mechanical ventilation requirements in pediatric intensive care.

Main Methods:

  • A prospective cohort study was conducted involving 72 children (1 month to 15 years) admitted to a single-center PICU.
  • Nutritional status was assessed using anthropometric parameters (Z-scores); malnutrition was defined as Z-scores ≤-2.
  • Adjusted Cox's regression analysis identified predictors of mechanical ventilation duration.

Main Results:

  • The prevalence of malnutrition was significant, with height-for-age Z-scores indicating malnutrition in 41.2% of patients.
  • Weight-for-age, height-for-age, and upper arm muscle area-for-age were significant predictors of longer mechanical ventilation duration.
  • Hazard ratios indicated increased risk associated with malnutrition: weight-for-age (2.73), height-for-age (2.49), and upper arm muscle area-for-age (5.22).

Conclusions:

  • Malnutrition, assessed via anthropometry, is strongly associated with the duration of mechanical ventilation in critically ill children.
  • Routine nutritional status assessment upon PICU admission is recommended for early identification of malnutrition.
  • Targeted nutritional rehabilitation for malnourished children in the PICU may improve outcomes and reduce ventilation duration.
Abstract

Keywords:
AnthropometryIntensive care unitMechanical ventilationPediatricsmalnutritionnutritional assessment

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