title: Enteral Nutrition Related Complications Relevant to Alteration of Formulas in Two Critically Ill Pediatric Patients.
abstract: The early institution of enteral nutrition is associated with beneficial outcomes and intestinal growth in pediatric patients. However, the number, frequency, and types of unfavorable events occurring with particular formulas are undefined. We experienced unexpected complications in two cases following a change in formula. One case diagnosed with myotubular myopathy experienced highly-increased gastric residuals and watery diarrhea leading to decreased calorie intake and weight loss. The second case with campomelic dysplasia suffered liver dysfunction and fever. In both cases, symptoms developed soon after of the change in formula and improved after resumption of the previous formula. Both cases had undergone tracheostomy and artificial ventilation, and had a history of feeding the same formula for an extended period of time. In chronic care patients such as ours, a change in formula may cause unexpected adverse events; therefore, caution is warranted.
authors: Nutrition Support Team, Social Insurance Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors: Nobuhiro
authors: N
authors: Akuzawa
authors: Nutrition Support Team, Social Insurance Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan; Nutrition Support Team, Social Insurance Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors: Aya Murata
authors: AM
authors: Takeuchi
authors: Nutrition Support Team, Social Insurance Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors: Jun
authors: J
authors: Tsukagoshi
authors: Nutrition Support Team, Social Insurance Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors: Ryoko
authors: R
authors: Kaneko
authors: Nutrition Support Team, Social Insurance Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors: Hiroshi
authors: H
authors: Naito
authors: Department of Pediatrics, Social Insurance Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors: Takahisa
authors: T
authors: Mizuno
authors: Department of Pediatrics, Social Insurance Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors: Yasuo
authors: Y
authors: Sunaga
authors: Department of Pediatrics, Social Insurance Gunma Chuo General Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors: Masahiko
authors: M
authors: Tashiro
keywords: Adverse event; Enteral feeding; Formula change; Pediatric