A nutritional support team in the pediatric intensive care unit: changes and factors impeding appropriate nutrition

Clin Nutr. 2007 Jun;26(3):355-63. doi: 10.1016/j.clnu.2007.02.004. Epub 2007 Apr 17.

Abstract

Background & aims: The aims of this study were to determine the impact of a nutritional support team (NST) intervention in a pediatric intensive care unit (PICU) and to identify the factors at admission that were associated to a delay to achieve a sustained optimal caloric intake (SOCI).

Methods: Caloric and protein intake and nutritional parameters were compared in 82 children in 2000 and 2003, respectively before and after the introduction of a NST. Predictive factors of a delay to achieve the SOCI were identified using multivariate analysis.

Results: There was no difference in 2000 and 2003, respectively, regarding cumulative caloric deficits (19+/-15.7 vs. 20.7+/-14.8 kcal/kg day), cumulative protein deficits (0.26+/-0.31 vs. 0.22+/-0.20 g/kg day), time to achieve a SOCI (7 vs. 7 days). Factors at admission associated with a delay to achieve a SOCI were a pediatric risk of mortality (PRISM) score > 10 (hazard ratio 0.58; 95% CI 0.44-0.77), a CRP > 50 mg/L (hazard ratio 0.49; 95% CI 0.35-0.70), a fluid restriction (hazard ratio 0.51; 95% CI 0.37-0.71), and a weight for age > 3rd centile (hazard ratio 0.54; 95% CI 0.41-0.72).

Conclusions: The intervention of a NST has not modified significantly the nutritional management. In pediatric intensive care, many factors identified at admission are associated with impairing appropriate nutrition.

MeSH terms

  • Critical Illness / therapy
  • Dietary Proteins / administration & dosage
  • Energy Intake / physiology
  • Female
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena*
  • Intensive Care Units, Pediatric / standards*
  • Male
  • Multivariate Analysis
  • Nutrition Policy
  • Nutritional Requirements*
  • Nutritional Status*
  • Nutritional Support*
  • Patient Care Team*
  • Retrospective Studies

Substances

  • Dietary Proteins