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Substandard feeding in children undergoing mechanical ventilation in pediatric intensive care unit: A retrospective
Meng Li1, Ying Wang1, Qingxiu Chen1
1Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China.
Insights
Substandard enteral nutrition feeding is common in mechanically ventilated pediatric intensive care unit (PICU) patients, affecting 65% of children. Diarrhea, vomiting, and slow infusion rates significantly contribute to this issue, necessitating targeted nursing interventions.
Area of Science:
- Pediatric critical care medicine
- Clinical nutrition
- Nursing science
Background:
- Enteral nutrition is crucial in the pediatric intensive care unit (PICU).
- Substandard enteral nutrition feeding in mechanically ventilated children is a significant concern with unclear incidence and impact.
- This practice can negatively affect patient prognosis.
Purpose of the Study:
- To evaluate the incidence of substandard enteral nutrition feeding in mechanically ventilated children within the PICU.
- To assess the nursing care status related to this feeding practice.
- To identify factors influencing substandard feeding in this patient population.
Main Methods:
- Retrospective cohort study design.
- Inclusion of 156 pediatric patients undergoing mechanical ventilation and enteral nutrition in a Chinese PICU.
- Statistical analyses including Pearson correlation and multivariate logistic regression were used to identify influencing factors.
Main Results:
- A high incidence rate of 65.38% for substandard enteral nutrition feeding was observed.
- Diarrhea, vomiting, and average infusion speed were statistically significant factors.
- Independent risk factors identified include diarrhea (OR=2.183), vomiting (OR=3.021), and slow infusion speed ≤40 mL/h (OR=2.605).
Conclusions:
- Substandard enteral nutrition feeding is prevalent in mechanically ventilated PICU children.
- Diarrhea, vomiting, and slow infusion rates are key influencing factors.
- Targeted nursing interventions focusing on managing gastrointestinal symptoms and optimizing infusion rates are recommended to reduce substandard feeding.
Background:
Enteral nutrition is a common yet vital practice in the pediatric intensive care unit (PICU). However, the status of substandard feeding of enteral nutrition in PICU children undergoing mechanical ventilation remains unclear and can be detrimental to the children's prognosis.
Objective:
This study aimed to evaluate the incidence, nursing care status, and influencing factors of substandard feeding in children undergoing mechanical ventilation in the PICU.
Methods:
This study employed a retrospective cohort design. Children undergoing mechanical ventilation and enteral nutrition in the PICU of a public hospital in China from 1 June 2021 to 31 December 2022 were selected using convenience sampling, and their characteristics were collected and evaluated. Pearson correlation analysis and multivariate logistic regression analysis were conducted to assess the influencing factors of substandard feeding in PICU children with mechanical ventilation.
Results:
A total of 156 PICU children undergoing mechanical ventilation were included for analysis in this study. The rate of substandard feeding in PICU children was 65.38%. Statistically significant differences were observed in diarrhea, vomiting, the use of sedatives, and average infusion speed between the substandard feeding group and the standard group (p <0.05). Pearson correlation results indicated that diarrhea (r = 0.595), vomiting (r = 0.602), and average infusion speed (r = 0.562) were correlated with substandard feeding and characteristics of included ICU children undergoing mechanical ventilation (p <0.05). Logistic regression results found that diarrhea (OR = 2.183, 95%CI: 1.855~2.742), vomiting (OR = 3.021, 95%CI: 2.256~4.294), and average infusion speed ≤40 mL/h (OR = 2.605, 95%CI: 1.921~3.357) were independent risk factors for substandard feeding in mechanically ventilated children in the ICU (p <0.05).
Conclusion:
The rate of substandard feeding in children with mechanical ventilation in the PICU was high. Diarrhea, vomiting, and slow infusion speed are important influencing factors for substandard feeding. It is suggested that nurses and other healthcare professionals take targeted measures, including the prevention and care of diarrhea and vomiting, as well as monitoring and adjusting the infusion speed of enteral nutrition, to reduce the occurrence of substandard feeding.
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