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Early Versus Late Enteral Nutrition in the Pediatric Critically-Ill Trauma Patient: A Retrospective Cohort Study

Eduardo Fastag1, Jhoanne Cana2, Salem Dehom3

  • 1Department of Pediatrics, Division of Pediatric Critical Care, Loma Linda University Children's Hospital, Loma Linda, CA, USA; Department of Pediatrics, Hennepin Healthcare, Minneapolis, MN, USA; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.

Journal of Pediatric Surgery
|February 2, 2025
PubMed

Insights

Early enteral nutrition (EEN) in pediatric intensive care units (PICUs) significantly reduces length of stay (LOS) in both the PICU and hospital. However, EEN did not impact the number of days patients required mechanical ventilation.

Area of Science:

  • Pediatric critical care medicine
  • Nutrition support
  • Trauma surgery

Background:

  • Early enteral nutrition (EEN) is crucial for critically ill children.
  • Timely initiation of nutrition support can impact patient outcomes.
  • Understanding barriers to EEN is important for optimizing care.

Purpose of the Study:

  • To evaluate the impact of early enteral nutrition (within 48 hours of admission) on length of stay (LOS) and mechanical ventilation days in the pediatric intensive care unit (PICU).
  • To identify barriers to the timely initiation of enteral nutrition in pediatric trauma patients.

Main Methods:

  • Retrospective cohort study including pediatric patients (<18 years) admitted with traumatic injuries.
  • Patients were categorized into early enteral nutrition (EEN, ≤48 hours) and late enteral nutrition (LEN, >48 hours) groups.
  • Multivariable negative binomial regression was used to compare PICU LOS, hospital LOS, and mechanical ventilation days, adjusting for confounders.

Main Results:

  • The study included 238 patients: 116 in the EEN group and 122 in the LEN group.
  • The EEN group experienced significantly shorter PICU LOS (aIRR 1.26, p=0.030) and hospital LOS (aIRR 1.36, p=0.005) compared to the LEN group.
  • No significant difference was observed in the number of mechanical ventilation days between the EEN and LEN groups.

Conclusions:

  • Initiating early enteral nutrition in the PICU is associated with reduced PICU and hospital length of stay.
  • The positive effect on LOS was observed after controlling for illness severity and other clinical factors.
  • Early enteral nutrition did not demonstrate an effect on the duration of mechanical ventilation in this cohort.
Abstract

Keywords:
ChildrenNutritionOutcomesPediatricTrauma

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