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Nutrient delivery in mechanically ventilated surgical patients in the pediatric critical care unit

Cristine S Velazco1, David Zurakowski2, Brenna S Fullerton1

  • 1Department of Surgery, Boston Children's Hospital; Harvard Medical School, Boston, MA 02115.

Journal of Pediatric Surgery
|November 19, 2016
PubMed

Insights

Critically ill pediatric surgical patients often receive inadequate protein via enteral nutrition (EN). Early EN initiation and fewer interruptions are crucial for improving nutrient delivery and patient outcomes.

Area of Science:

  • Pediatric critical care medicine
  • Surgical nutrition
  • Pediatric intensive care

Background:

  • Inadequate nutrient intake is linked to adverse outcomes in critically ill children.
  • Optimizing macronutrient delivery is essential for pediatric intensive care unit (PICU) patients.

Purpose of the Study:

  • To evaluate macronutrient (specifically protein) delivery in pediatric surgical patients within the PICU.
  • To identify factors associated with inadequate nutrient intake in this population.

Main Methods:

  • Prospective international cohort study of mechanically ventilated children aged 1 month to 18 years.
  • Analysis focused on surgical patients, defining inadequate protein intake as less than 60% of the prescribed goal.
  • Data collected on enteral nutrition (EN) delivery, initiation time, and interruptions.

Main Results:

  • 66% of surgical patients received EN, initiated on median PICU day 2.
  • EN delivery was interrupted in 68% of patients for a median of 9 hours.
  • Two-thirds of patients received less than 60% of their prescribed enteral protein goal; inadequate delivery correlated with delayed EN initiation and longer interruptions.

Conclusions:

  • Enteral protein delivery is frequently inadequate in critically ill pediatric surgical patients.
  • Early initiation of EN and minimizing interruptions may enhance protein delivery.
  • Improving enteral protein delivery has the potential to improve outcomes in this vulnerable patient group.
Abstract

Keywords:
Enteral nutritionInterruptionPICUProteinSurgical

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