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Early enteral feeding in the pediatric intensive care unit
M J Chellis1, S V Sanders, H Webster
1Primary Children's Medical Center, University of Utah School of Medicine, Salt Lake City 84113, USA.
Insights
Early enteral nutrition is safe and feasible for critically ill children. This feeding method helps patients meet nutritional needs quickly and reduces healthcare costs.
Area of Science:
- Pediatric critical care medicine
- Clinical nutrition
- Gastroenterology
Background:
- Critically ill pediatric patients often require nutritional support.
- Early initiation of enteral nutrition is a key component of critical care management.
Purpose of the Study:
- To assess the feasibility and safety of early enteral nutrition in critically ill pediatric patients.
- To evaluate the clinical outcomes and cost-effectiveness of this feeding strategy.
Main Methods:
- A cohort of 42 critically ill pediatric patients (5 days to 18 years) received transpyloric nasoenteric tube feedings.
- Patients were mechanically ventilated, and many required vasoactive medications.
- Feeding tolerance and achievement of caloric goals were monitored.
Main Results:
- No complications, including aspiration, were documented with early enteral feeding.
- All patients achieved caloric goals within 48 hours.
- Enteral nutrition replaced 256 days of parenteral nutrition, saving an estimated $425 per day.
Conclusions:
- Early enteral nutrition is a feasible and well-tolerated approach for critically ill pediatric patients.
- This feeding strategy is safe, effective in meeting nutritional needs, and cost-effective.
Background:
The purpose of this study was to evaluate the feasibility and safety of early enteral feedings of critically ill pediatric patients.
Methods:
The subject population of 42 critically ill patients ranged in age from 5 days to 18 years (mean 5.8 years), mean weight 17 kg. Transpyloric nasoenteric tubes were placed in all patients by a nonfluoroscopic bedside technique. All subjects were mechanically ventilated; 32 (76%) were on one or more vasoactive medications. Six (15%) patients were fed for more than 13 days while on vasoactive support and pharmacological paralysis.
Results:
There were no documented complications of early enteral feeding, including aspiration. All patients were able to achieve caloric goals within 48 hours of beginning enteral feedings. All patients developed regular stool patterns despite periodic absence of bowel sounds. Enteral feedings replaced 256 days of total parenteral nutrition. Estimated patient charge savings averaged $425 for each day of enteral feedings.
Conclusions:
Early enteral feedings are feasible, well tolerated, and cost effective in critically ill pediatric patients.