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Revista Cubana de Pediatría

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2022, Number 1

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Rev Cubana Pediatr 2022; 94 (1)

Nutritional Support Practices in Pediatric Intensive Care Unit

Tantaleán-da Fieno JAJ, Palomo-Luck OP, León-Paredes RJ
Full text How to cite this article

Language: Spanish
References: 20
Page: 1-13
PDF size: 579.06 Kb.


Key words:

intensive care unit, enteral nutrition, parenteral nutrition, pediatrics.

ABSTRACT

Introduction: Children in critical condition are at high risk of malnutrition, both because of their pre-existing conditions and because of the nutritional practices applied during hospitalization, which can increase the risk of morbidity and mortality.
Objective: Assess nutritional support practices and factors involved in the delivery of energy and protein in mechanically ventilated children.
Methods: Prospective observational study with analytical aspects, where a cohort of 40 mechanically ventilated patients (1-17 years) admitted to the pediatric intensive care unit of the National Institute of Children's Health was evaluated. Demographic and clinical data were recorded; daily caloric and protein intake and adequacy, interruptions in nutrition, time of stay, among others were counted.
Results: At the time of admission, 70% presented malnutrition, 77.5; 12.5; and 7.5% received enteral, parenteral and both kinds of nutrition, respectively. The onset of nutritional support on average was 3.5 days. 24% of the caloric requirements and 31% of the calculated proteins were reached. The main causes of interruption of enteral feeding in 39.4% of the time were fasting by intubation or extubation, 24.2% by surgery and 15% by elevated gastric residue.
Conclusions: There is a high rate of malnutrition and poor adequacy of the prescribed caloric and protein requirement. The implementation of a nutrition protocol can facilitate the nutritional management of the pediatric patient in critical condition.


REFERENCES

  1. Roudi F, Khademi G, Ranjbar G, Pouryazdanpanah M, Pahlavani N, Boskabady A, et al. The Effects of Implementation of a Stepwise Algorithmic Protocol for Nutrition Care Process in Gastro-Intestinal Surgical Children in Pediatric Intensive Care Unit Clin Nut ESPEN. 2021;43:250-8. DOI: https://doi.org/10.1016/j.clnesp.2021.04.004.

  2. Aponte ADB, Pinzón OLE, Aguilera PAO. Tamizaje nutricional en paciente pediátrico hospitalizado: revisión sistemática. Nutr Hosp. 2018;35(5):1221-8. DOI: https://dx.doi.org/10.20960/nh.1658

  3. Etchegaray K, Bustos E. Evaluación y apoyo nutricional en el paciente pediátrico críticamente enfermo: Revisión de la literatura. Rev chilena Nut. 2021;48(1):95-102. DOI: http://dx.doi.org/10.4067/S0717-75182021000100095

  4. Mehta NM, Bechard LJ, Cahill N, Wang M, Day A, Duggan CP, et al. Nutritional practices and their relationship to clinical outcomes in critically ill children--an international multicenter cohort study. Crit Care Med. 2012;40(7):2204-11. DOI: http://dx.doi.org/10.1097/CCM.0b013e31824e18a8

  5. Cieza-Yamunaqué LP. Soporte nutricional en el paciente pediátrico crítico. Revista Facultad Medicina Humana. 2018;18(4):101-8. DOI: http://dx.doi.org/10.25176/RFMH.v18.n4.1737

  6. Mehta NM, Skillman HE, Irving SY, Coss‐Bu JA, Vermilyea S, Farrington EA, et al. 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. J Parenter Enteral Nutr. 2017;41(5):706-42. DOI: https://doi.org/10.1177/0148607117711387

  7. Patel JJ, Codner P. Controversies in Critical Care Nutrition Support. Crit Care Clin. 2016;32(2):173-89. DOI: https://doi.org/10.1016/j.ccc.2015.11.002

  8. Preiser JC, van Zanten ARH, Berger MM, Biolo G, Casaer M, Doig GS, et al. Metabolic and nutritional support of critically ill patients: consensus and controversies. Crit Care. 2015;19(1):35. DOI: https://doi.org/10.1186/s13054-015-0737-8

  9. World Health Organization. Energy and Protein Requirements: Report of a Joint FAO/WHO/UNU Expert Consultation, Technical Report Series 724. Geneva: WHO; 1985. [acceso 21/01/2021]. Disponible en: Disponible en: https://apps.who.int/iris/handle/10665/39527

  10. Mehta N, Compher C. ASPEN Board of Directors. ASPEN Clinical Guidelines: Nutrition Support of the Critically Ill Child. J Parenter Enteral Nutr. 2009;33(3):260-76. DOI: https://doi.org/10.1177/0148607109333114

  11. Bechard L, Duggan C, Touger R, Scott J, Rothpletz P, Byham L, et al. Nutritional status based on body mass index is associated with morbidity and mortality in mechanically ventilated critically ill children in the PICU. Crit Care Med. 2016;44:1530-7. DOI: https://doi.org/10.1097/CCM.0000000000001713

  12. De Souza Menezes F, Leite HP, Koch Nogueira PC. Malnutrition as an independent predictor of clinical outcome in critically ill children. Nutrition. 2012;28(3):267-70. DOI: https://doi.org/10.1016/j.nut.2011.05.015

  13. Martinez EE, Mehta NM. The science and art of pediatric critical care nutrition. Curr Opin Crit Care. 2016;22(4):316-24. DOI: https://doi.org/10.1097/MCC.0000000000000316

  14. Mejía LL, López SG, Barrera IN, Bautista-Silva M, Vela-Amieva M. Tratamiento nutricional en niños con COVID-19. Acta Pediátr Méx. 2020;41(4S1):109-20. DOI: http://dx.doi.org/10.18233/APM41No4S1ppS109-S1202059

  15. Galera-Martínez R, López-Ruzafa E, López AM, Moráis AL, Lama RAM. Actualización en el soporte nutricional del paciente pediátrico críticamente enfermo. Acta Pediatr Esp. 2017 [acceso 26/05/2021];75(7-8):e117-23. Disponible en: Disponible en: https://www.proquest.com/openview/767ae4ae1da1fcbd38190fa41f7a5426/1?pq-origsite=gscholar&cbl=31418

  16. Galeano S, Castañeda Á, Guzmán E, Montoya M, Jaimes F. Deuda calórica en una cohorte de pacientes hospitalizados en unidades de cuidado intensivo. Rev Chil Nutr. 2019;46(5):535-44. DOI: http://dx.doi.org/10.4067/S0717-75182019000500535

  17. Joosten K, Kerklaan D, Verbruggen S. Nutritional support and the role of the stress response in critically ill children. Curr Opin Clin Nutr Metab Care. 2016;19(3):226-33. DOI: https://doi.org/10.1097/MCO.0000000000000268

  18. Fivez T, Kerklaan D, Mesotten D, Verbruggen S, Wouters PJ, Vanhorebeek I, et al. Early versus Late Parenteral Nutrition in Critically Ill Children. N Engl J Med. 2016;374:1111-22. DOI: https://doi.org/10.1056/NEJMoa1514762

  19. Moullet C, Schmutz E, Depeyre JL, Perez MH, Cotting J, Chaparro CJ. Physicians' perceptions about managing enteral nutrition and the implementation of tools to assist in nutritional decision-making in a paediatric intensive care unit. Aust Crit Care. 2020;33(3):219-27. DOI: https://doi.org/10.1016/j.aucc.2020.03.003

  20. Alsohime F, Assiry G, Al-Salman M, Alabdulkareem W, Almuzini H, Alyahya M, et al. Barriers to the delivery of enteral nutrition in pediatric intensive care units: A national survey. Int J Pediatr Adolesc Med. 2020. DOI: https://doi.org/10.1016/j.ijpam..12.003




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Rev Cubana Pediatr. 2022;94