title: Effect of early nutritional support on intensive care unit length of stay and neurological status at discharge in children with severe traumatic brain injury.
abstract: Pediatric severe traumatic brain injury treatment guidelines for nutrition indicate that "there are insufficient data to support a treatment guideline for this topic" (P. D. Adelson et al., 2003). Based on adult studies, the guideline provided an option for practitioners to start nutritional support within 72 hours of admission and full replacement by day 7. This retrospective, descriptive correlation study examined the timing of nutritional supplement initiation and the timing of achieving full caloric intake in relation to length of stay (LOS) in the intensive care unit (ICU) and patient disposition status at discharge from hospital in children 8-18 years old. Median time to initiation of nutrition was 1.5 days (0.02-11.9 days), and full caloric goals were achieved in 3.4 days (0.5-19.6 days). Median ICU LOS was 2.1 days (0.01-97.9 days). Overall, 48% of patients were discharged home; 28% experienced mild, moderate, or severe disability; and 24% either died or survived in a vegetative state. Early initiation and achieving full caloric intake were both positively correlated with shorter LOS in the ICU (p < .01, Spearman's rho correlational matrix) and better disposition status at discharge from the hospital (p < .05, Kruskal-Wallis test).
authors.affiliation: California State University San Bernardino, CA, USA. ataha@llu.edu
authors.forename: Asma A
authors.initials: AA
authors.lastname: Taha
authors.forename: Lina
authors.initials: L
authors.lastname: Badr
authors.forename: Cheryl
authors.initials: C
authors.lastname: Westlake
authors.forename: Vivien
authors.initials: V
authors.lastname: Dee
authors.forename: Mathur
authors.initials: M
authors.lastname: Mudit
authors.forename: Kathyrne L
authors.initials: KL
authors.lastname: Tiras
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000293:Adolescent; D001930:Brain Injuries / Q000178:diet therapy* / Q000401:mortality / Q000451:nursing*; D002648:Child; D003422:Critical Care / Q000379:methods* / Q000706:statistics & numerical data; D002149:Energy Intake; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D018529:Nutritional Support / Q000379:methods* / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D018458:Persistent Vegetative State / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013041:Specialties, Nursing / Q000379:methods*; D016896:Treatment Outcome