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Impact of nutritional status on the outcome of critically ill pediatric patients
Samriddhi Jain1, Amit Agrawal2, Shweta Sharma1
1Department of Pediatrics, Gandhi Medical College, Bhopal 462022, Madhya Pradesh, India.
Insights
Malnutrition is prevalent in critically ill children, significantly increasing their mechanical ventilation and hospital stay duration. While mortality rates were similar, nutritional status impacts recovery time in the pediatric intensive care unit.
Area of Science:
- Pediatric Intensive Care
- Clinical Nutrition
- Critical Illness Outcomes
Background:
- Malnutrition is a frequent issue in pediatric intensive care units (PICUs).
- Limited data exists on the specific impact of malnutrition on critically ill children's outcomes.
- Understanding this impact is crucial for improving patient care and recovery.
Purpose of the Study:
- To determine the effect of nutritional status on the outcomes of critically ill children admitted to a PICU.
- To analyze the association between malnutrition and key clinical indicators in this population.
Main Methods:
- An observational study was conducted over one year in a tertiary care teaching institute.
- 210 children (1 month to 14 years) admitted to the PICU for at least 24 hours were included.
- Data on anthropometrics, demographics, mechanical ventilation, PICU/hospital stay, and outcomes were collected and analyzed.
Main Results:
- The prevalence of malnutrition was 51.9% among the 210 pediatric patients.
- Malnutrition was significantly associated with longer durations of mechanical ventilation (P=0.001) and PICU stay (P=0.001).
- A significant association was also found between malnutrition and hospital stay duration (P=0.021), though mortality rates did not differ significantly between malnourished and well-nourished groups (P=0.241).
Conclusions:
- Malnutrition is common in critically ill children and is linked to poorer clinical outcomes, including extended ventilation and hospitalization.
- While mortality was comparable, nutritional status significantly influences the length of recovery and resource utilization in the PICU.
- Early nutritional assessment and intervention may be vital for improving outcomes in this vulnerable group.
Background:
Malnutrition among patients admitted to a pediatric intensive care unit (PICU) is common. However, there is a lack of data on its impact on the critically ill.
Aim:
To assess the impact of nutritional status on the outcome of critically ill children admitted to PICU.
Methods:
This observational study was conducted in a tertiary care teaching institute for one year, including 210 children aged 1 month to 14 years admitted to a 15-bed PICU for a minimum of 24 hours. Patients with less than 24 hours of PICU stay, who received palliative care, or with syndromic short stature were excluded. Relevant data were collected including anthropometric details, demographic data, duration of mechanical ventilation (MV), PICU, and hospital stay and outcome. Malnourished and well-nourished groups were compared using an independent t-test, one-way analysis of variance, and χ 2 test.
Results:
Among 210 patients, there were 129 males and 81 females. There were 57 (27.1%) children less than 6 months of age, 95 (45.2%) between 6 months and 5 years, and 58 (27.6%) more than 5 years of age. The prevalence of malnutrition in the study sample was 51.9% (n = 109). The overall mortality was 22.9% (48/210), 26.6% (29/109) among malnourished, and 18.8% (19/101) among well-nourished children (P = 0.241). A significant association was found between the severity of malnutrition and duration of MV (P = 0.001), PICU stay (P = 0.001), and hospital stay (P = 0.021).
Conclusion:
Malnutrition is common in critically ill children and contributes to poor clinical outcomes such as duration of MV, PICU, and hospital stay. However, mortality was comparable in both groups.
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