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Nutritional practices and adequacy in children supported on extracorporeal membrane oxygenation

Chengsi Ong1, Yee Hui Mok2, Zhen Han Tan3

  • 1Nutrition and Dietetics, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, 12 Science Drive 2, 117549, Singapore.

Clinical Nutrition ESPEN
|June 18, 2018
PubMed

Insights

Nutritional intake is often inadequate in children on extracorporeal membrane oxygenation (ECMO). Improving enteral nutrition (EN) energy adequacy in these critically ill children may reduce mortality risk.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pediatric Extracorporeal Membrane Oxygenation
  • Nutritional Support in Critical Illness

Background:

  • Extracorporeal membrane oxygenation (ECMO) use in children is rising, yet optimal nutritional strategies remain unclear.
  • Understanding nutritional adequacy is crucial for improving outcomes in pediatric ECMO patients.

Purpose of the Study:

  • To assess nutritional adequacy in children receiving ECMO.
  • To identify factors influencing enteral nutrition (EN) delivery and its impact on mortality.

Main Methods:

  • Retrospective review of pediatric ECMO patients (2010-2016).
  • Analysis of enteral and parenteral energy and protein intake within the first 7 days of ECMO.
  • Definition of nutritional adequacy as intake versus requirements percentage.

Main Results:

  • Overall energy and protein adequacy were low (48.3% and 44.8%, respectively).
  • Parenteral nutrition constituted the majority of caloric and protein intake.
  • Lower EN energy adequacy was significantly associated with increased hospital mortality (aOR 0.93; P=.048).

Conclusions:

  • Nutritional adequacy, particularly EN, is insufficient in pediatric ECMO patients.
  • Optimizing EN energy delivery in children on ECMO may be a key strategy to reduce mortality.
  • Further research into nutritional support for pediatric ECMO is warranted.
Abstract

Keywords:
Critically ill childrenEnteral nutritionExtracorporeal membrane oxygenationMortalityParenteral nutritionPediatric intensive care unit

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