Author Of 2 Presentations
NUTRITIONAL SUPPORT IN SPANISH PEDIATRIC CRITICAL CARE UNITS
- María José Solana García, Spain
- Gema Manrique, Spain
- Miriam García,
- Reyes Fernandez,
- Eva Rodríguez Carrasco,
- María Miñambres,
- Carmen Santiago,
- Silvia Redondo,
- Concha Goñi,
- María Slocker,
- Arancha Gonzalez-Posada,
- Monica Balaguer,
- Lucia Moran,
- Crisitna Yun,
- Carmen María Martín,
- Nutrition and digestive complications study group of the Pediatric Spanish Intensive care Society Secip,
- Jorge López, Spain
Abstract
Background
Nutritional support during pediatric critical illness is a fundamental goal of critical cares, which requires careful assesment and prescription. However, no nutritional protocols exists in Spain. In order to elaborate them, it is important to know first-hand about nutritional support practices in PICUs across the country.
Objectives
To review the nutritional support of children admitted to Spanish Pediatric Intensive Care Units (PICUs).
Methods
Prospective cross-sectional multicenter study performed in 13 Spanish PICUs. Children who received artificial nutrition (enteral or parenteral) were included. Patient and feeding characteristics during their admission were collected.
Results
Eigthy four children were included (54% males), 47.6% were younger than one year old. The most frequent diagnosis was cardiopathy (28.6%), followed by respiratory (22.6%) and neurological diseases (11.9%). Enteral nutrition was administered to 82% of the patients. Early enteral nutrition (<48 hours) was prescribed in 39.3% of the patients, being started in the first 24 hours of admission in 17.9%. Mean time to start enteral feeds was 1.1±0.93 days. Enteral nutrition was administered by nasogastric tube, continuous in 50% and discontinuous in 27.4% of patients, and by transpyloric tube in 21.4%. In total, 18 patients received parenteral nutrition. Mean enteral calorie intake was 43.4(IQR 35.2) Kcal/Kg/day and, attending to the maximum calorie intake, the mean was 83.3(IQR 20.4) Kcal/Kg/day.
Conclusion
Most patients received enteral nutrition during admission but only 39% of them had early enteral feeding. The most frequent way of enteral feeding was by nasogastric tube. Mean enteral calorie intake did not achieved the international recommendations.
NUTRITIONAL STATUS AND SUPPORT OF CHILDREN ADMITTED TO SPANISH INTENSIVE CARE UNITS
- María José Solana García, Spain
- Miriam García,
- Gema Manrique, Spain
- Reyes Fernandez,
- Eva Rodríguez Carrasco,
- María Miñambres,
- Carmen Santiago,
- Silvia Redondo,
- Concha Goñi,
- María Slocker,
- Arancha Gonzalez-Posada,
- Monica Balaguer,
- Lucia Moran,
- Carmen María Martín,
- Crisitna Yun,
- Nutrition and digestive complications study group of the Pediatric Spanish Intensive care Society Secip,
- Jorge López, Spain
Abstract
Background
Nutrition support in Pediatric Intensive Care Units (PICUs) requires careful assesment and prescription because it can affect patients’ outcome.
Objectives
To review the nutritional status of children admitted to Spanish PICUs.
Methods
Prospective cross-sectional multicenter study performed in 13 Spanish PICUs. Children who received artificial nutrition (enteral or parenteral) were included. Anthropometric data, feeding characteristics and digestive complications during their admission were collected. Nutritional status was determined by Waterloo index.
Results
Eigthy four children were included. On admission, 42.3% of the patients suffered from acute malnutrition, 37.3% chronic malnutrition and 12.8% overnutrition. 17.9% of the children did not received any enteral nutrition, this percentage was higher in youngest patients (p=0.038). Mean enteral calorie intake was 43.4(IQR 35.2) Kcal/Kg/day and, the mean of maximum calorie intake was 83.3(IQR 20.4) Kcal/Kg/day. Only 39.3% of the patients received early enteral nutrition (<48 hours). Significant correlations were observed between days to onset of enteral nutrition and PRIMSIII (r= 0.33, p=0.006), maximum calorie intake (r= -0.25, p=0.04), and age (r= 0.35, p=0.03). There was a correlation between mean calorie intake and days on mechanical ventilation (r=0.31, p=0.02). The most frequent complication was vomiting (64%) and abdominal distension (15.5%). Enteral nutrition was not associated to severe digestive complications.
Conclusion
A high percentage of critically ill children are malnourished on admission. Only 39.3% of patients had early enteral feeding. Delayed enteral nutrition is related to higher PRIMSIII, less maximum calorie intake and younger patients. The most frequent complication was vomiting, no serious digestive complications were detected.