J Korean Med Sci.  2013 Jul;28(7):1055-1059. 10.3346/jkms.2013.28.7.1055.

Avoidable Causes of Delayed Enteral Nutrition in Critically Ill Children

• Lee H
• Koh SO
• Kim H
• Sohn MH
• Kim KE
• Kim KW

• KMID: 1777502
• DOI: http://doi.org/10.3346/jkms.2013.28.7.1055

Abstract

To evaluate the incidence of delayed enteral nutrition (EN) and identify avoidable causes of delay, we retrospectively reviewed medical records of 200 children (median age [range]; 37.5 [1-216] months) who stayed in the intensive care unit (ICU) for a minimum of 3 days. Among 200 children, 115 received EN following ICU admission with a median time of EN initiation of 5 days after admission. Of these, only 22 patients achieved the estimated energy requirement. A significant decrease in the final z score of weight for age from the initial assessment was observed in the non-EN group only (-1.3+/-2.17 to -1.57+/-2.35, P<0.001). More survivors than non-survivors received EN during their ICU stay (61.2% vs 30.0%, P=0.001) and received EN within 72 hr of ICU admission (19.8% vs 3.3%, P=0.033). The most common reason for delayed EN was gastrointestinal (GI) bleeding, followed by altered GI motility and hemodynamic instability. Only eight cases of GI bleeding and one case of altered GI motility were diagnosed as active GI bleeding and ileus, respectively. This study showed that the strategies to reduce avoidable withholding EN are necessary to improve the nutrition status of critically ill children.

Keyword

Enteral Nutrition; Parenteral Nutrition; Critical Illness; Child

MeSH Terms

Adolescent
Child
Child, Preschool
Critical Illness
Energy Intake
Enteral Nutrition/*statistics & numerical data
Female
Gastrointestinal Hemorrhage/*diagnosis
Gastrointestinal Motility
Humans
Ileus/*diagnosis
Infant
Intensive Care Units
Male
Nutritional Status
Retrospective Studies
Treatment Outcome
Withholding Treatment/*statistics & numerical data

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