1. Achieving energy goals at day 4 after admission in critically ill children; predictive for outcome?
- Author
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de Betue CT, van Steenselen WN, Hulst JM, Olieman JF, Augustus M, Mohd Din SH, Verbruggen SC, Tibboel D, and Joosten KF
- Subjects
- Acute Disease, Adolescent, Anti-Bacterial Agents administration & dosage, Child, Child, Preschool, Enteral Nutrition, Hospitalization, Humans, Infant, Infant, Newborn, Intensive Care Units, Pediatric, Length of Stay, Malnutrition complications, Netherlands, Nutritional Status, Prospective Studies, Respiration, Artificial, Treatment Outcome, Critical Illness therapy, Energy Intake, Malnutrition therapy
- Abstract
Background & Aims: 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., Methods: 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)., Results: 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 (n = 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., Conclusions: 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., (Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)
- Published
- 2015
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