Prevalence, Risk Factors and Impact of Nutrition Interruptions in Critically Ill Children

Area of Science:

• Pediatric Critical Care Medicine
• Clinical Nutrition
• Healthcare Quality Improvement

Background:

• Enteral nutrition interruptions (ENI) are frequent in pediatric intensive care units (PICUs).
• Limited data exists on the specific characteristics and causes of ENIs in this vulnerable population.
• Understanding ENI patterns is crucial for optimizing nutritional support in critically ill children.

Purpose of the Study:

• To investigate the prevalence, characteristics, and associated factors of enteral nutrition interruptions in critically ill children.
• To identify common reasons for ENIs and assess their preventability.
• To determine the impact of ENIs on nutritional intake and patient outcomes.

Main Methods:

• A cross-sectional, multicenter study was conducted involving critically ill children receiving enteral nutrition.
• Data on ENI frequency, duration, and classification (PICU procedures, procedures outside PICU, feeding intolerance, other) were collected.
• Statistical analysis explored associations between ENIs and patient characteristics (e.g., PRISM score, diagnoses, ventilation status).

Main Results:

• Enteral nutrition interruptions affected 37.3% of the 75 enrolled patients, with a median duration of 5 hours.
• Procedures performed outside the PICU (PPOP) were the most common cause (41.5%).
• ENIs were more prevalent in children with cardiac disease, higher PRISM scores, and longer PICU stays, leading to reduced caloric and protein intake.

Conclusions:

• Enteral nutrition interruptions are a significant issue in the PICU, particularly for children with complex conditions and higher illness severity.
• Preventable interruptions occurred frequently, highlighting a need for improved care coordination and management strategies.
• Addressing ENIs is essential to ensure adequate nutritional delivery and support recovery in critically ill pediatric patients.