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[Nutritional support in children with pneumonia on mechanical ventilation by short-peptide enteral nutrition formula]
Xian-Jie Huang1, Fei-Fei Guo, Fan Li
1Department of Pediatric Intensive Care Unit, Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China. junying.qiao@163.com.
Insights
Malnutrition is common in children with pneumonia requiring mechanical ventilation. Short-peptide formula improved outcomes and tolerance in these critically ill pediatric patients.
Area of Science:
- Pediatric Intensive Care
- Clinical Nutrition
- Respiratory Medicine
Background:
- Pneumonia requiring mechanical ventilation in children is associated with high rates of malnutrition and nutritional risk.
- Early identification and intervention are crucial for improving outcomes in critically ill pediatric patients.
Purpose of the Study:
- To determine the incidence of malnutrition and nutritional risk in pediatric patients with pneumonia on mechanical ventilation.
- To evaluate the efficacy of short-peptide enteral nutrition formula in this patient population.
Main Methods:
- A prospective randomized controlled study involving 68 children with severe pneumonia requiring mechanical ventilation.
- Comparison of short-peptide enteral nutrition formula (experimental group) versus intact-protein enteral nutrition formula (control group).
- Assessment of nutritional status, risk scores, serum protein levels, gastrointestinal tolerance, and clinical outcomes.
Main Results:
- High incidence of malnutrition (38%) and nutritional risk (93%) was observed in the study population.
- The experimental group showed significantly shorter mechanical ventilation duration, hospital stay, and improved weight gain and gastrointestinal tolerance.
- No significant difference in ventilator-associated pneumonia or overall disease outcome was noted between groups.
Conclusions:
- Children with pneumonia on mechanical ventilation exhibit high rates of malnutrition and nutritional risk.
- Short-peptide enteral nutrition formula demonstrates superior efficacy in improving treatment outcomes and is suitable for critically ill pediatric patients requiring mechanical ventilation.
Objective:
To observe the incidence of malnutrition and nutritional risk in children with pneumonia on mechanical ventilation in the pediatric intensive care unit (PICU), and to explore the nutritional support effect of short-peptide enteral nutrition formula.
Methods:
A total of 68 children with severe pneumonia who were hospitalized in the PICU from October 2017 to October 2018 and required mechanical ventilation were enrolled for a prospective randomized controlled study. The children were randomly divided into a control group and an experimental group. Through the nasogastric feeding tube, the experimental group received the short-peptide enteral nutrition formula, and the control group received the intact-protein enteral nutrition formula. The weight-for-age Z score, STRONGkids nutritional risk score, and pediatric critical illness score of the two groups were evaluated. The serum levels of total protein, albumin, and prealbumin (PA) on admission and before discharge were measured. The gastrointestinal tolerance and clinical outcome indicators of the two groups were observed.
Results:
Among the 68 mechanically ventilated children, 26 (38%) had malnutrition, including moderate malnutrition (10 cases, 15%) and severe malnutrition (16 cases, 24%); 10 cases (15%) had malnutrition at discharge. Sixty-three children (93%) had nutritional risk, including moderate nutritional risk in 21 cases and high nutritional risk in 42 cases. The moderate and high nutritional risk rates of the critical and extreme critical groups were significantly higher than those of the non-critical group (P<0.05). Compared with the control group, the experimental group had significantly shorter duration of mechanical ventilation and total length of hospital stay, significantly higher serum PA level and weight growth rate, and significantly better gastrointestinal tolerance (P<0.05). There were no significant differences in the incidence of ventilator-associated pneumonia and disease outcome between the two groups (P>0.05).
Conclusions:
The detection rates of malnutrition and nutritional risk in children with pneumonia on mechanical ventilation are relatively high. Short-peptide enteral nutrition formula can help improve their treatment outcome and are more suitable for nutritional support in critically ill children on mechanical ventilation.
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