Prognostic significance of energy and protein adequacy provided by enteral nutrition in children with sepsis or severe sepsis in pediatric intensive care unit

doi:10.3969/j.issn.1006-7795.2016.02.004

Abstract

Abstract: Objective To examine the prognostic implications of the adequacy of energy and protein intake provided by enteral nutrition (EN) in children with sepsis or severe sepsis in pediatric intensive care unit (PICU). Methods We conducted a prospective observational study of consecutive children with sepsis or severe sepsis in PICU of Beijing Children's Hospital from Nov. 2012 to April 2013. Children's energy and protein intake by EN were daily recorded and their adequacy was calculated according to 64 kcal·kg^-1·d^-1 and 1.5 g·kg^-1·d^-1 respectively. The prognosis variables were compared between children with adequate EN and inadequate EN. Results Totally 62 children aged 9.37 months were included. The adequacy of energy by EN was 0.84±0.38, while the adequacy of protein was 0.94±0.46. Children reached adequate energy and protein intake by EN during observational periods were 25 (40.32%) and 29 (46.8%) cases, respectively. Children with inadequate energy intake by EN were older (P=0.02), with lower pediatric critical illness score (PCIS) (77.12±10.21 vs 82.88±7.03, P=0.02) and longer invasive mechanical ventilation duration (P=0.03). Children with inadequate protein intake by EN had higher weight (P=0.00), higher percent of children with severe sepsis (42.4% vs 17.2%, P=0.03) and more dysfunctional organs (P=0.01). Children with inadequate energy (16.2% vs 4.0%) and protein (15.2% vs 6.9%) intake by EN also had higher mortality at 28th hospital day. Conclusion Majority of children with sepsis or severe sepsis in PICU suffered from inadequate energy and protein intake by EN, and most with older age and higher weight. Inadequate energy intake by EN may associate with longer invasive mechanical ventilation and higher hospital fees, while inadequate protein intake by EN may be associated with increased risk of organ dysfunction. Inadequate energy or protein intake by EN may increase mortality of children with sepsis or severe sepsis in PICU.

Key words: pediatric intensive care unit, sepsis, adequacy of enteral nutrition

CLC Number:

R723.1

Fang Boliang, Qian Suyun. Prognostic significance of energy and protein adequacy provided by enteral nutrition in children with sepsis or severe sepsis in pediatric intensive care unit[J]. Journal of Capital Medical University, 2016, 37(2): 125-129.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2016.02.004

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2016/V37/I2/125

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