Nutritional goals, prescription and delivery in a pediatric intensive care unit.
OBJECTIVE
The aim of this study was to compare prescription and delivery of nutrition to predefined nutritional targets, and identify risk factors associated with inadequate nutritional intake.


METHODS
In 84 mechanically ventilated critically ill children with length of stay on the PICU of at least 3 days, we observed prescribed and delivered percentages of predefined targets for intake of calories and macronutrients during a 10-months study period. Factors associated with inadequate intake were identified.


RESULTS
On the third day of admission 92.9% of the patients received nutritional therapy. The caloric goal was reached on day 5, mainly supplied by fat and carbohydrates. Mean actual daily protein delivery was about 75% of the target during the entire study period. Use of catecholamines or neuromuscular blocking agents was a risk factor for caloric undernutrition, whereas there were no specific risk factors for overnutrition.


CONCLUSIONS
Nutritional therapy should be started in the early phase of critical illness, including adequate supply of protein. In order to prevent deficits to accumulate, parenteral nutrition should be added in an early phase, if nutritional needs cannot be met by enteral nutrition.
de Neef
Marjorie
M
Pediatric Intensive Care Unit, G8-131, Emma Children's Hospital/Academic Medical Center, P.O. Box 22700, 1100DE Amsterdam, The Netherlands. m.deneef@amc.uva.nl
Geukers
Vincent G M
VG
Dral
Aafke
A
Lindeboom
Robert
R
Sauerwein
Hans P
HP
Bos
Albert P
AP
D000293:Adolescent; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D016638:Critical Illness / Q000628:therapy*; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000592:standards / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D044623:Nutrition Therapy / Q000592:standards*; D018529:Nutritional Support / Q000379:methods* / Q000706:statistics & numerical data; D012121:Respiration, Artificial
D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins