An evaluation of enteral nutrition practices and nutritional provision in children during the entire length of stay in critical care

Jackie Mara, Emma Gentles, Hani A Alfheeaid, Krystalia Diamantidi, Neil Spenceley, Mark Davidson, David Young, Konstantinos Gerasimidis

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Provision of optimal nutrition in children in critical care is often challenging. This study evaluated exclusive enteral nutrition (EN) provision practices and explored predictors of energy intake and delay of EN advancement in critically ill children. Data on intake and EN practices were collected on a daily basis and compared against predefined targets and dietary reference values in a paediatric intensive care unit. Factors associated with intake and advancement of EN were explored. Data were collected from 130 patients and 887 nutritional support days (NSDs). Delay to initiate EN was longer in patients from both the General Surgical and congenital heart defect (CHD) Surgical groups [Median (IQR); CHD Surgical group: 20.3 (16.4) vs General Surgical group: 11.4 (53.5) vs Medical group: 6.5 (10.9) hours; p ≤ 0.001]. Daily fasting time per patient was significantly longer in patients from the General Surgical and CHD Surgical groups than those from the Medical group [% of 24 h, Median (IQR); CHD Surgical group: 24.0 (29.2) vs General Surgical group: 41.7 (66.7) vs Medical group: 9.4 (21.9); p ≤ 0.001]. A lower proportion of fluids was delivered as EN per patient (45% vs 73%) or per NSD (56% vs 73%) in those from the CHD Surgical group compared with those with medical conditions. Protein and energy requirements were achieved in 38% and 33% of the NSDs. In a substantial proportion of NSDs, minimum micronutrient recommendations were not met particularly in those patients from the CHD Surgical group. A higher delivery of fluid requirements (p < 0.05) and a greater proportion of these delivered as EN (p < 0.001) were associated with median energy intake during stay and delay of EN advancement. Fasting (31%), fluid restriction (39%) for clinical reasons, procedures requiring feed cessation and establishing EN (22%) were the most common reasons why target energy requirements were not met. Provision of optimal EN support remains challenging and varies during hospitalisation and among patients. Delivery of EN should be prioritized over other "non-nutritional" fluids whenever this is possible.
LanguageEnglish
Article number186
Number of pages9
JournalBMC Pediatrics
Volume14
DOIs
Publication statusPublished - 21 Jul 2014

Fingerprint

Nutrition
Enteral Nutrition
Critical Care
Length of Stay
Entire
Defect Group
Congenital Heart Defects
Evaluation
Nutritional Support
Fluid
Proportion
Energy Intake
Energy
Fasting
Children
Requirements
Pediatric Intensive Care Units
Micronutrients
Target
Pediatrics

Keywords

  • adolescent
  • child
  • child, preschool
  • critical care
  • dietary proteins
  • energy intake
  • enteral nutrition
  • female
  • Great Britain
  • humans
  • infant
  • newborn infants
  • intensive care units, pediatric
  • length of stay
  • male
  • micronutrients
  • nutritional requirements
  • nutritional status
  • outcome and process assessment (health care)
  • proportional hazards models

Cite this

Mara, J., Gentles, E., Alfheeaid, H. A., Diamantidi, K., Spenceley, N., Davidson, M., ... Gerasimidis, K. (2014). An evaluation of enteral nutrition practices and nutritional provision in children during the entire length of stay in critical care. BMC Pediatrics, 14, [186]. https://doi.org/10.1186/1471-2431-14-186
Mara, Jackie ; Gentles, Emma ; Alfheeaid, Hani A ; Diamantidi, Krystalia ; Spenceley, Neil ; Davidson, Mark ; Young, David ; Gerasimidis, Konstantinos. / An evaluation of enteral nutrition practices and nutritional provision in children during the entire length of stay in critical care. In: BMC Pediatrics. 2014 ; Vol. 14.
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An evaluation of enteral nutrition practices and nutritional provision in children during the entire length of stay in critical care. / Mara, Jackie; Gentles, Emma; Alfheeaid, Hani A; Diamantidi, Krystalia; Spenceley, Neil; Davidson, Mark; Young, David; Gerasimidis, Konstantinos.

In: BMC Pediatrics, Vol. 14, 186, 21.07.2014.

Research output: Contribution to journalArticle

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AU - Mara, Jackie

AU - Gentles, Emma

AU - Alfheeaid, Hani A

AU - Diamantidi, Krystalia

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AU - Davidson, Mark

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AU - Gerasimidis, Konstantinos

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KW - enteral nutrition

KW - female

KW - Great Britain

KW - humans

KW - infant

KW - newborn infants

KW - intensive care units, pediatric

KW - length of stay

KW - male

KW - micronutrients

KW - nutritional requirements

KW - nutritional status

KW - outcome and process assessment (health care)

KW - proportional hazards models

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