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Postpyloric vs gastric enteral nutrition in critically ill children: A single-center retrospective cohort study

Enid E Martinez1,2,3, Patrice Melvin4, Charles Callif1

  • 1Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.

JPEN. Journal of Parenteral and Enteral Nutrition
|February 1, 2023
PubMed

Insights

Postpyloric enteral nutrition (PPEN) led to better delivery of nutrition compared to gastric enteral nutrition (GEN) in critically ill children. This suggests PPEN may be a more effective method for nutritional support in this population.

Area of Science:

  • Pediatric critical care medicine
  • Clinical nutrition
  • Gastroenterology

Background:

  • Enteral nutrition (EN) is crucial for critically ill patients.
  • Delivery methods include gastric (GEN) and postpyloric (PPEN) routes.
  • Optimizing EN delivery is essential for patient outcomes.

Purpose of the Study:

  • To compare the delivery of enteral nutrition (EN) between postpyloric EN (PPEN) and gastric EN (GEN) in pediatric intensive care unit patients.
  • To evaluate the efficiency of EN delivery based on timing and adequacy.

Main Methods:

  • Retrospective, single-center study of pediatric patients (<21 years) in an intensive care unit receiving EN for ≥48 hours.
  • Propensity score matching (1:1) of PPEN and GEN groups based on demographics, clinical characteristics, and disease severity.
  • Comparison of time to EN initiation, EN adequacy (percentage of prescribed volume), and time to achieve 60% of prescribed EN volume.

Main Results:

  • Matched cohort of 46 PPEN and 46 GEN patients.
  • EN adequacy was significantly higher in the PPEN group on days 1-3 and 7 post-initiation (P<0.05).
  • PPEN patients had a greater likelihood of achieving 60% of prescribed EN volume (HR 1.84, P=0.028).

Conclusions:

  • Postpyloric enteral nutrition (PPEN) is associated with superior enteral nutrition delivery compared to gastric enteral nutrition (GEN).
  • These findings support PPEN as a potentially more effective method for nutritional support in critically ill pediatric patients.
Abstract

Keywords:
childrencritical careenteral nutritiongastricpostpyloric

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