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Assessment of Child Anthropometry in a Large Epidemiologic Study
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Impact of Obesity on Outcomes in Critically Ill Children

Esther T Davis1,2, Li Xie3, Yosef Levenbrown4,2

  • 11 Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|August 10, 2017
PubMed

Insights

Obesity in critically ill children was linked to less need for intubation and inotropic support. However, overweight or obese status did not impact mortality or mechanical ventilation duration in pediatric intensive care unit patients.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pediatric Obesity Research
  • Clinical Outcomes in Pediatrics

Background:

  • The 'obesity paradox' suggests obesity may be protective in critically ill adults.
  • Limited data exists on obesity's effect in critically ill pediatric populations.
  • Understanding weight status impact is crucial for pediatric intensive care unit (PICU) management.

Purpose of the Study:

  • To investigate if obesity offers a protective effect in critically ill children.
  • To compare outcomes between normal weight, overweight, and obese pediatric patients in the ICU.
  • To determine the association of weight status with mortality, intubation, and support needs.

Main Methods:

  • Retrospective cohort study of 1817 pediatric patients (aged 2-18 years) admitted to a PICU.
  • Patients categorized by body mass index (BMI) into normal weight, overweight, and obese groups.
  • Outcomes analyzed: mortality, need for intubation, inotropic support, and mechanical ventilation duration.

Main Results:

  • Overweight and obese pediatric patients showed a significantly lower requirement for intubation and inotropic support compared to normal-weight peers.
  • No significant difference in mortality rates was observed across weight categories.
  • Duration of mechanical ventilation did not differ between normal weight, overweight, and obese pediatric patients.

Conclusions:

  • In critically ill children, being overweight or obese is associated with a reduced need for intubation and inotropic support.
  • Overweight and obesity status were not found to be protective or a risk factor for mortality in this pediatric cohort.
  • Findings suggest weight status influences specific interventions but not overall survival or ventilation duration in critically ill children.
Abstract

Keywords:
body mass indexintubationmortalitynutritionpediatric critical care

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