Association between gastrointestinal complications of enteral feeding and the nutritional state in critical pediatric patients
Article Sidebar
Main Article Content
Abstract
Objective: To establish the relationship between nutritional status and enteral nutrition complications in patients hospitalized in a Pediatric Intensive Care Unit. Design: Analytical, observational, cross-sectional study between October 2020 and March 2021. Setting: Pediatric Intensive Care Unit of the National Hospital “Prof. Alejandro Posadas”, Buenos Aires, Argentina. Patients: Between 1 and 179 months of age, with a stay >48 h and exclusive enteral nutrition, selected by non-probabilistic convenience sampling. Interventions: Identification of gastrointestinal symptoms in patients with exclusive enteral nutrition, during their hospital stay. Primary endpoint: Gastrointestinal complications related to enteral nutrition (diarrhea, abdominal distension, constipation). Results: 113 patients (55% boys, 45% girls) with a median age of 28 months. The median stay in Therapy was 9 days (range 5.5-18). 57% had at least one gastrointestinal symptom, and the most frequent was abdominal distension. A significant association (pv 0.014) was found between patients with obesity and diarrhea. Conclusions: An association was observed between the nutritional diagnosis at admission and the symptoms related to enteral nutrition. Likewise, a relationship was found between longer hospital stay and a higher prevalence of gastrointestinal symptoms
Article Details
The magazine does not retain the reproduction rights (copyright) so the authors can republish their works with the sole mention of the original publication source.
References
Elshafie A, El-Lahony D, Omar Z, Zein O, Wael B, Hanem G. Nutrition in critically Ill pediatric patients: a systemic review. Menoufia Medical Journal. 2019; 32(3).
Mehta NM, Jaksic T. Nutritional Aspects of Specific Disease States. Pediatric critical care nutrition. 1st ed. McGraw Hill Education: 2015. p 663-673.
Mehta NM. Approach to enteral feeding in the PICU. Nutri Clin Pract. 2009;24(3):377-87.
Tume I, Valla F, Joosten K, Chaparro C, Latten L, Marino L, et al. Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations. Intensive Care Med. 2020;46:411–425
Metha NM, McAller D, Hamilton S, Naples E, Leavitt K, Mitchell P, et al. Challenges to Optimal Enteral Nutrition in a Multidisciplinary Pediatric Intensive Care Unit. JPEN J Parenter Enteral Nutr. 2010;34(1):38-45
Alberda C, Gramlich L, Jones N, Jeejeebhoy K, Day A, Dhaliwal R, et al. The relationship between nutritional intake and clinical outcomes in critically ill patients: results of an international multicenter observational study. Intensive Care Med. 2009;35(10):1728-37.
Kerklaan D, Fivez T, Mehta NM, Mesotten D, Van Rosmalen J, Hulst J, et al. Worldwide Survey of Nutritional Practices in PICU’s. Pediatr Crit Care Med. 2016; 17(1):10-8
Sabatino A, Regolisti G, Maggiore U, Fiaccadori E. Protein/Energy Debt in Critically Ill Children in the Pediatric Intensive Care Unit: Acute Kidney Injury As a Major Risk Factor. Review Article. J Ren Nutr. 2014. 24 (4): 209-218
Marino L, Moullet C, Chaparro J. The impact of nutrition on clinical outcomes in the critically ill child. Pediatr Med2020; 3:21.
Cantón OS, Ferreiro SR, Bautista SC. Guía nutrición pediátrica hospitalaria. 4ta edición. 2016. p 55-69
Prieto MB, López-Herce Cid, J. Malnutrition in the critically ill child: the importance of enteral nutrition. Int. J. Environ. Res. Public Health. 2011, 8, 4353-4366;
Wong J, Ong C, Han W, Lee J. Protocol-Driven Enteral Nutrition in Critically Ill Children: A Systematic Review. JPEN J Parenter Enteral Nutr. 2014;38 (1):29–39.
Zamberlan P, Figueiredo A, Leone C, Ferferbaum R, Suely T. Nutrition Therapy in a Pediatric Intensive Care Unit: Indications, Monitoring, and Complications. JPEN J Parenter Enteral Nutr 2011; 35(4): 523-5
Tume LN, Valla FV. A review of feeding intolerance in critically ill children. Eur J Pediatr.2018; 177 (11):1675-83.
Metha NM, Skillman H, Irving Y, Coss-Bu J, Vermilyea S, Farington E, et col. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2017 41 (5); 706–742.
Ardila Gomez I, Bonilla Gonzalez C, Martinez Palacio P, Mercado Santis E, Tibaduiza J, Contreras J, et col. Nutritional Support of the Critically Ill Pediatric Patient: Foundations and Controversies. Clinical Medicine Insights: Trauma and Intensive Medicine. 2017; 8; 1–7.
Solana M, López-Herce J, López J. Feed intolerance and post pyloric feeding in the critically ill child. Pediatr Med 2020;3:19
Eveleens RD, Joosten KFM, de Koning BAE, Hulst J, Verbuggen S. Definitions, predictors and outcomes of feeding intolerance in critically ill children: A systematic review. Clin Nutr. 2020; 39(3):685-93.
Kyle U, Jaimon N, Coos-Bu J. Nutrition Support in Critically Ill Children: Under delivery of Energy and Protein Compared with Current Recommendations. J Acad Nutr Diet 2012 ;112(12):1987-92
Metha N, McAleer D, Hamilton S, Naples E, Leavitt K, Mitchell P, et al. Challenges to optimal enteral nutrition in a multidisciplinary pediatric intensive care unit. JPEN J Parenter Enteral Nutr. 2010; 34(1): 38–45. doi:10.1177/0148607109348065.
Agudelo GM, Giraldo NA, Aguilar N, Restrepo B, Vanegas M, Alzate S, et col. Incidence of nutritional support complications in patient hospitalized in wards. Multicentric study. Colombia Médica. 2013; 43(2): 147-153
Hoffman M, Schwarz C, Furst S, Starchi C, Lobmeyr E, Sendlholfer G, et col. Risks in Management of Enteral Nutrition in Intensive Care Units: A Literature Review and Narrative Synthesis. Nutrients 2021; 13(1): 82-92