Association between protein intake and muscle wasting in critically ill children: A prospective cohort study

Area of Science:

• Pediatric critical care medicine
• Intensive care unit (ICU) outcomes
• Nutritional support in critical illness

Background:

• Optimizing recovery for pediatric critical illness survivors is crucial.
• Muscle mass wasting is a significant concern during critical illness.
• Identifying factors influencing muscle wasting is important for improving patient outcomes.

Purpose of the Study:

• To investigate the relationship between quadriceps muscle mass wasting and protein/energy intake in pediatric critical illness.
• To assess muscle wasting using ultrasound measurements.
• To explore factors affecting muscle mass reduction during and after critical illness.

Main Methods:

• Prospective cohort study conducted in a mixed cardiac and general pediatric intensive care unit in England.
• Serial ultrasound measurements of quadriceps muscle thickness were performed at days 1, 3, 5, 7, and 10.
• Analysis included 34 children with a median age of 6.65 months.

Main Results:

• All 34 children experienced quadriceps muscle wasting, averaging 7.75% during critical care admission.
• Muscle mass wasting was not significantly associated with protein or energy intake within 72 hours of admission.
• No significant correlation was found with illness severity, C-reactive protein levels, or steroid use. Neuromuscular blocking drug exposure showed a non-significant trend towards increased muscle wasting.

Conclusions:

• Early protein and energy intake (at 72 hours) were not associated with quadriceps muscle mass wasting in pediatric critical illness survivors.
• Further research may be needed to identify effective interventions to mitigate muscle loss in this population.