Achieving energy goals at day 4 after admission in critically ill children; predictive for outcome?. Issue 1 (February 2015)

• Record Type: Journal Article
• Authors: de Betue, C.T.I.; van Steenselen, W.N.; Hulst, J.M.; Olieman, J.F.; Augustus, M.; Mohd Din, S.H.; Verbruggen, S.C.A.T.; Tibboel, D.; Joosten, K.F.M.
• Is Part Of: Clinical nutrition. Volume 34:Issue 1(2015:Feb.)
• Page Start: 115
• Page End: 122
• Publication Date: 2015-02
• Subjects: Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2014.01.019
• Languages: English
• ISSNs: 0261-5614

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background & aims</title> <p id="abspara0010">Adequate nutritional intake is essential during pediatric intensive care admission. We investigated whether achievement of energy intake goals at day 4 after admission and route of nutrition were associated with improved outcome.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">Observational study using prospectively acquired data. Patients receiving enteral and/or parenteral nutrition were included. The energy intake target range at day 4 after admission was 90–110% of resting energy expenditure +10%. Acute malnutrition was defined as weight-for-age <−2 SD. Clinical outcome measures were length of stay, days on ventilator, duration of antibiotics and number of new infections. Data as median (min–max).</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">Of 325 subjects (age 0.14 (0.0–18.0) year), 19% were acutely malnourished upon admission. Median 86% of energy goals were administered via the enteral route. With enteral energy intake, 7% of patients were fed within the target range, 50% were fed below and 43% were fed above the target range. In a subgroup (<italic>n</italic> = 223) the acutely malnourished proportion at discharge (26%) was not significantly different from that upon admission (22%). Whether the energy intake was below, within or above the target range did not affect changes in clinical outcome, nor did the route of nutrition.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">Acute malnutrition was highly prevalent upon admission and at discharge. With our nutritional protocol we achieved high rates of (enteral) energy intake. A high percentage of our population received enteral energy above the target energy range. However, there was no association between the amount of energy intake or route of nutrition and clinical outcome.</p> </sec> </abstract>