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Nutritional support in critically ill children.pdf

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Nutritional support in critically ill children

Clinical Nutrition (2003) 22(4): 365–369 r 2003 Elsevier Science Ltd. All rights reserved. doi:10.1016/S0261-5614(03)00033-5 ORIGINAL ARTICLE Nutritional support in critically ill children R.M.TAYLOR, V. R. PREEDY,y A. J. BAKER,n G. GRIMBLEz n Institute of Liver Studies, King’s College Hospital, Denmark Hill, London, UK, wDepartment of Nutrition Dietetics, King’s College London, London, UK, and zSchool of Life Sciences,Whiteland, College, University of Surrey Roehampton,West Hill, London, UK (Correspondence to: RMT, Paediatric Liver Service, King’s College Hospital, London SE5 9RS, UK) Abstract.Background aims: Enteral nutrition is the feedingmethodof choice during critical illness, but in some cases as few as 25% are fed appropriately.The aimwas to retrospectively review the administration of nutrition to critically ill children. Methods:The notes of 95 children over the age of1year who were in PICUZ3 days were reviewed and information related to the delivery of nutritionwas obtained. Results:Fifty-nine per cent were fedwithin 24hof admission. Enteralnutritionwas administered 54%of the time,10% required parenteral nutrition and 9.5% received no nutritional support. Children only received a median 58.8 (range 0^ 277)% of their energy requirements, which could not be optimised until the 10th intensive care day. Energy intake was greater when supplemented with parenteral nutrition. Parenteral nutrition administration was interrupted 3 times while enteral nutrition was stopped 264 times, mainly to allow other clinical procedures to take place. For 75% of the study time, children had abnormal bowel patterns. Seventy-nine per cent were constipated for 3^21days and 43% had diar- rhoea of unknown aetiology. Conclusion:This was a retrospective study to describe the e?ciency of nutritional support in critically ill children.We have shown that it is possible to administer enteralnutrition safely.However, the di?erencebetweendesirable intake and actual intake achieved sugges