Feasibility of Enteral Nutrition in Pediatric Septic Shock at a Tertiary Center in Vietnam

Area of Science:

• Pediatric critical care medicine
• Nutritional support in critical illness
• Septic shock management

Background:

• Septic shock in children requires timely and effective nutritional support.
• Early enteral nutrition (EN) is hypothesized to improve outcomes in critically ill children.
• Resource-limited settings present unique challenges for implementing advanced critical care interventions.

Purpose of the Study:

• To assess the feasibility and clinical characteristics of early EN (within 48 hours) in pediatric septic shock.
• To compare outcomes between early and late EN groups in a resource-limited pediatric intensive care unit (PICU).
• To identify clinical factors associated with early EN initiation and its impact on patient outcomes.

Main Methods:

• Retrospective observational study in a Vietnamese tertiary PICU.
• Inclusion of children aged 1 month to 16 years with septic shock.
• Categorization into early EN (≤48 hours) and late EN (>48 hours) groups for comparative analysis.

Main Results:

• Early EN was initiated in 42.3% of 52 patients, with successful implementation and no severe gastrointestinal complications.
• Patients receiving early EN had lower baseline illness severity.
• The early EN group exhibited lower mortality, reduced mechanical ventilation days, and less need for renal replacement therapy.

Conclusions:

• Early enteral nutrition is feasible and appears safe for pediatric septic shock patients in resource-limited PICUs.
• Favorable outcomes were observed with early EN, but causality is not established due to study limitations.
• Further prospective research is warranted to confirm the benefits of early EN in this population.