What are the factors that influence the attainment of satisfactory energy intake in pediatric intensive care unit patients receiving enteral or parenteral nutrition?

What are the factors that influence the attainment of satisfactory energy intake in pediatric intensive care unit patients receiving enteral or parenteral nutrition?

Author Menezes, Fernanda Souza de Autor UNIFESP Google Scholar
Leite, Heitor Pons Autor UNIFESP Google Scholar
Nogueira, Paulo Cesar Koch Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: Children admitted to the intensive care unit (ICU) are at risk of inadequate energy intake. Although studies have identified factors contributing to an inadequate energy supply in critically ill children, they did not take into consideration the length of time during which patients received their estimated energy requirements after having achieved a satisfactory energy intake. This study aimed to identify factors associated with the non-attainment of estimated energy requirements and consider the time this energy intake is maintained.Methods: This was a prospective study involving 207 children hospitalized in the ICU who were receiving enteral and/or parenteral nutrition. the outcome variable studied was whether 90% of the estimated basal metabolic rate was maintained for at least half of the ICU stay (satisfactory energy intake). the exposure variables for outcome were gender, age, diagnosis, use of vasopressors, malnutrition, route of nutritional support, and Pediatric Index of Mortality and Pediatric Logistic Organ Dysfunction scores.Results: Satisfactory energy intake was attained by 20.8% of the patients, within a mean time of 5.07 +/- 2.48 d. in a multivariable analysis, a diagnosis of heart disease (odds ratio 3.62, 95% confidence interval 1.03-12.68, P = 0.045) increased the risk of insufficient energy intake, whereas malnutrition (odds ratio 0.43, 95% confidence interval 0.20-0.92, P = 0.030) and the use of parenteral nutrition (odds ratio 0.34, 95% confidence interval 0.15-0.77, P = 0.001) were protective factors against this outcome.Conclusion: A satisfactory energy intake was reached by a small proportion of patients during their ICU stay. Heart disease was an independent risk factor for the non-attainment of satisfactory energy intake, whereas malnutrition and the use of parenteral nutrition were protective factors against this outcome. (C) 2013 Elsevier Inc. All rights reserved.
Keywords Energy intake
Malnutrition
Nutritional therapy
Parenteral nutrition
Enteral nutrition
Intensive care unit
Pediatric
Heart disease
Language English
Date 2013-01-01
Published in Nutrition. New York: Elsevier B.V., v. 29, n. 1, p. 76-80, 2013.
ISSN 0899-9007 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 76-80
Origin http://dx.doi.org/10.1016/j.nut.2012.04.003
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000313138200013
URI http://repositorio.unifesp.br/handle/11600/35652

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