[Artificial nutrition in pediatric intensive care units].
OBJECTIVE
To perform an epidemiologic study of artificial nutrition in critically-ill pediatric patients.


METHODS
A multicenter, prospective and descriptive study was conducted in 23 Spanish intensive care units (ICU) (18 pediatric ICUs and five pediatric/neonatal ICUs) over a 1-month period. Artificial nutrition (AN) was required by 165 critically-ill patients (21.4 %). Data on diagnosis, severity, treatment, type of nutrition administered and complications were analyzed.


RESULTS
A total of 54.4 % of the participants were younger than 1 year, 19.4 % were aged between 1 and 5 years old, 15.7 % between 5 and 10 years old and 13.4 % were older than 10 years. ICU mean length stay was 11 days. One hundred six patients were administered enteral nutrition (EN): 67.9 % continuous nasogastric EN, 27.4 intermittent nasogastric EN, 16 % nasojejunal EN, 2.8 % gastrostomy EN. Eighty patients required parenteral nutrition (PN): 86.3 % central PN, 20 % peripheral PN. No significant differences were found between patients with EN and PN in mean energy intake, days receiving AN, diagnosis at admission to the ICU, disease severity (measured by PRISM III) or intensive support techniques. The EN group required greater inotropic support. Patients undergoing mechanical ventilation had equal mortality independent of the type of AN. The most common complications in EN were: 17.9 % emesis, 13.2 % abdominal distension, 11.3 % diarrhea, 4.7 % gastric residual volumes, and 6.6 % hypokalemia. In PN complications consisted of: 5 % catheter related infection, 1.3 % thrombophlebitis, 7.5 % hyponatremia, 3.8 % hypoglycemia, 6.3 % hypophosphatemia and 3.8 % hypertriglyceridemia.


CONCLUSIONS
EN provides critically-ill children with adequate energy intake and is well tolerated. Therefore, if there are no contraindications, EN should be the system of choice in the critically-ill patient requiring AN.
Pérez-Navero
J L
JL
Unidades de Cuidados Intensivos Pediátricos, Grupo de Trabajo de Nutrición de la Sociedad Española de Cuidados Intensivos Pediátricos, Spain. ucip.hrs.sspa@juntadeandalucia.es
Dorao Martínez-Romillo
P
P
López-Herce Cid
J
J
Ibarra de la Rosa
I
I
Pujol Jover
M
M
Hermana Tezanos
María T
MT
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D008297:Male; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000706:statistics & numerical data*