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Enteral Nutritional Therapy in Pediatric Autologous Transplantation: A Descriptive Cohort Study

Andressa Florencio da Silva1,2, Vera Lucia Bosa2,3, Estela Beatriz Behling1,2

  • 1Nutrition Service. Multiprofessional Health Residency Program: Onco-Hematology, Porto Alegre Clinical Hospital, Porto Alegre, Brazil.

Nutrition and Cancer
|July 19, 2024
PubMed

Insights

Early enteral nutrition is crucial for pediatric hematopoietic stem cell transplant patients. However, nutritional status declined during treatment, highlighting the need for improved enteral nutrition protocols.

Area of Science:

  • Pediatric Hematology
  • Transplant Nutrition
  • Gastroenterology

Background:

  • Pediatric hematopoietic stem cell transplantation (HSCT) necessitates tailored nutritional support.
  • Early enteral nutrition (EN) is recognized for its benefits in pediatric HSCT.
  • This study examines EN practices in autologous HSCT recipients.

Purpose of the Study:

  • To analyze the utilization and impact of enteral nutrition therapy in pediatric patients undergoing autologous HSCT.
  • To assess nutritional and clinical variables during the early post-transplant period.
  • To identify trends in EN formula selection and the need for parenteral nutrition.

Main Methods:

  • Descriptive cohort study utilizing electronic medical records (2017-2022).
  • Inclusion of pediatric patients undergoing autologous HSCT receiving EN.
  • Assessment of nutritional, clinical, and biochemical data at four time points: Day 0, +5, +10, and +15.

Main Results:

  • Fifty patients were included; nasoenteral tubes were typically placed pre-transplant (D-4) with feeding initiated (D-3).
  • Formula type shifted from normocaloric polymeric to hypocaloric semi-elemental by D+10 due to increased diarrhea and mucositis.
  • 35% required parenteral nutrition by D+15, and overall nutritional status worsened from admission to discharge.

Conclusions:

  • Early EN initiation aligns with established practices and literature recommendations.
  • Worsening clinical conditions (diarrhea, mucositis) necessitate formula adjustments and can lead to parenteral nutrition reliance.
  • Development of specific protocols and guidelines for EN in pediatric HSCT is essential for optimizing patient outcomes.

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