Abstract
Provision of optimal nutrition is often difficult to achieve in the critically ill
child, but can improve with better nutritional support practices. This study evaluated
the joint impact of the introduction of enteral feeding practice guidelines and participation
of dietitians in daily ward rounds on enteral nutrition (EN) intake and practices
in children in intensive care. Nutritional intake and EN practices were audited before
(period A) and after (period B) the introduction of enteral feeding practice guidelines
and participation of dietitians in daily ward rounds in a pediatric intensive care
unit. Information was collected on a daily basis and nutritional intake was compared
with predefined targets and the United Kingdom dietary reference values. There were
65 patients and 477 nutritional support days in period A and 65 patients and 410 nutritional
support days in period B. Basal metabolic rate (BMR) energy requirements were achieved
in a larger proportion of nutritional support days in period B (BMR achieved [% nutritional
support days]; period A: 27% vs period B: 48.9%; P<0.001). In patients admitted for nonsurgical reasons, median energy, protein, and
micronutrient intake improved significantly. In the same group, the percentage of
daily fluid intake delivered as EN increased post implementation (period A: median=66.8%;
interquartile range=40.9 vs period B: median=79.6%; interquartile range=35.2; P<0.001). No significant changes were seen in patients admitted for corrective heart
surgery. Implementation of better EN support practice can improve nutritional intake
in some patients in critical care, but can have limited benefit for children admitted
for corrective heart surgery.
Keywords
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Biography
E. Gentles is a highly specialist dietitians in pediatric critical care, Paediatric Intensive Care Unit and Department of Dietetics and Nutrition, Royal Hospital for Sick Children, NHS Greater Glasgow and Clyde, Glasgow, UK.
Biography
J. Mara is a highly specialist dietitians in pediatric critical care, Paediatric Intensive Care Unit and Department of Dietetics and Nutrition, Royal Hospital for Sick Children, NHS Greater Glasgow and Clyde, Glasgow, UK.
Biography
K. Diamantidi is a registrar in pediatrics, Human Nutrition, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Biography
H. A. Alfheeaid is a clinical nutritionist, Human Nutrition, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Biography
K. Gerasimidis is a lecturer in clinical nutrition, Human Nutrition, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Biography
N. Spenceley is a consultant pediatric intensivists, Paediatric Intensive Care Unit, Royal Hospital for Sick Children, NHS Greater Glasgow and Clyde and Human Nutrition, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Biography
M. Davidson is a consultant pediatric intensivists, Paediatric Intensive Care Unit, Royal Hospital for Sick Children, NHS Greater Glasgow and Clyde and Human Nutrition, School of Medicine, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Article info
Publication history
Published online: June 21, 2014
Accepted:
April 25,
2014
Footnotes
Supplementary materials: Figures 1 and 2 and Table 4 are available at www.andjrnl.org
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT There is no funding to disclose.
Identification
Copyright
© 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
